Occupational therapy for rheumatoid arthritis

Steultjens EEMJ, Dekker JJ, Bouter LM, Schaardenburg DD, Kuyk M-AMAH, Van den Ende ECHM

Summary

Occupational therapy for rheumatoid arthritis

Does occupational therapy help people with rheumatoid arthritis?
To answer this question, scientists analysed 38 studies. The studies tested over 1700 people who had rheumatoid arthritis. People were either counseled, trained in skills or trained to move or do daily chores with less pain, taught to protect their joints, given splints, taught to use assistive devices, or had no therapy. Not all studies were high quality but this Cochrane Review provides the best evidence about occupational therapy that we have today.

What is occupational therapy and how could it help rheumatoid arthritis?
Rheumatoid arthritis is a disease in which the body's immune system attacks its own healthy tissues. The attack happens mostly in the joints of the feet and hands and causes redness, pain, swelling and heat around the joint. People with rheumatoid arthritis can find it difficult to do daily chores such as dressing, cooking, cleaning and working. Occupational therapists can give advice on how to do every day activities with less pain or advice on how to use splints and assistive devices.

How well does it work?
A high quality study showed that people could do daily chores better after having occupational therapy with training, advice and counseling. Two high quality studies showed that people given advice about how to protect their joints could do daily chores better than people with no advice or another type of occupational therapy. But both therapies did not help overall well-being or pain.

Another high quality study showed that people trained to move or do daily activities could move just as well as and with the same amount of pain as people who did not have occupational therapy. The strength of their grip was also improved immediately after wearing a splint. But hand movement was less after wearing a splint

There was not enough information to say whether advice about using assistive devices is helpful.

What is the bottom line?
There is "gold" level evidence that occupational therapy can help people with rheumatoid arthritis to do daily chores such as dressing, cooking and cleaning and with less pain. Benefits are seen with occupational therapy that includes training, advice and counseling and also with advice on joint protection.

Splints can decrease pain and improve the strength of one's grip, but it may decrease hand movement.