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Jo Adams - One of the best experts on this subject based on the ideXlab platform.
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Clinical and cost effectiveness of arthritis gloves in rheumatoid arthritis (A-GLOVES): randomised controlled trial with economic analysis
'Springer Science and Business Media LLC', 2021Co-Authors: Hammond Alison, Jo Adams, Prior Yeliz, Cotterill Sarah, Sutton Chris, Camacho Elizabeth, Heal Calvin, Hough Yvonne, O’neill, Terence W., Firth JillAbstract:Background: Arthritis (or compression) gloves are widely prescribed to people with rheumatoid arthritis and other forms of Hand arthritis. They are prescribed for daytime wear to reduce Hand Pain and improve Hand function, and/or night-time wear to reduce Pain, improve sleep and reduce morning stiffness. However, evidence for their effectiveness is limited. The aims of this study were to investigate the clinical and cost effectiveness of arthritis gloves compared to placebo gloves on Hand Pain, stiffness and function in people with rheumatoid arthritis and persistent Hand Pain. Methods: A parallel randomised controlled trial, in adults (≥ 18 years) with rheumatoid or undifferentiated inflammatory arthritis at 16 National Health Service sites in the UK. Patients with persistent Hand Pain affecting function and/or sleep were eligible. Randomisation (1:1) was stratified by recent change (or not) in medication, using permuted blocks of random sizes. Three-quarter-finger length arthritis gloves (Isotoner®: applying 23-32 mmHg pressure) (intervention) were compared to loose-fitting placebo gloves (Jobskin® classic: providing no/minimal pressure) (control). Both gloves (considered to have similar thermal qualities) were provided by occupational therapists. Patients and outcome assessors were blinded; clinicians were not. The primary outcome was dominant Hand Pain on activity (0–10) at 12 weeks, analysed using linear regression and intention to treat principles. Results: Two hundred six participants were randomly assigned (103 per arm) and 163 (84 intervention: 79 control) completed 12-week follow-up. Hand Pain improved by 1.0 (intervention) and 1.2 (control), an adjusted mean difference of 0.10 (95% CI: − 0.47 to 0.67; p = 0.72). Adverse events were reported by 51% of intervention and 36% of control group participants; with 6 and 7% respectively, discontinuing glove wear. Provision of arthritis gloves cost £129, with no additional benefit. Conclusion: The trial provides evidence of no clinically important effect of arthritis gloves on any of the trial outcomes (Hand Pain, function and stiffness) and arthritis gloves are not cost-effective. The clinical and cost-effectiveness results support ceasing provision of arthritis gloves in routine clinical practice. Funding: National Institute for Health Research. Trial registration: ISRCTN, ISRCTN25892131; Registered 05/09/2016: retrospectively registered.
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Exercises for Hand osteoarthritis: A systematic review of clinical practice guidelines and consensus recommendations
Physical Therapy Reviews, 2019Co-Authors: Beatrice E. A. Sankah, Maria Stokes, Jo AdamsAbstract:AbstractBackground: Individuals with Hand osteoarthritis (OA) often experience Hand Pain, joint stiffness and reduced grip strength, which affect performance of everyday functional tasks. There is ...
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The effects of arthritis gloves on people with Rheumatoid Arthritis or Inflammatory Arthritis with Hand Pain: a study protocol for a multi-centre randomised controlled trial (the A-GLOVES trial)
BMC musculoskeletal disorders, 2017Co-Authors: Yeliz Prior, Jo Adams, Chris J Sutton, Sarah Cotterill, Elizabeth Camacho, Nazina Arafin, Jill Firth, Terence W. O'neill, Yvonne Hough, Wendy JonesAbstract:Arthritis gloves are regularly provided as part of the management of people with rheumatoid arthritis (RA) and undifferentiated (early) inflammatory arthritis (IA). Usually made of nylon and elastane (i.e. Lycra®), these arthritis gloves apply pressure with the aims of relieving Hand Pain, stiffness and improving Hand function. However, a systematic review identified little evidence supporting their use. We therefore designed a trial to compare the effectiveness of the commonest type of arthritis glove provided in the United Kingdom (Isotoner gloves) (intervention) with placebo (control) gloves (i.e. larger arthritis gloves providing similar warmth to the intervention gloves but minimal pressure only) in people with these conditions. Participants aged 18 years and over with RA or IA and persistent Hand Pain will be recruited from National Health Service Trusts in the United Kingdom. Following consent, participants will complete a questionnaire booklet, then be randomly allocated to receive intervention or placebo arthritis gloves. Within three weeks, they will be fitted with the allocated gloves by clinical specialist rheumatology occupational therapists. Twelve weeks (i.e. the primary endpoint) after completing the baseline questionnaire, participants will complete a second questionnaire, including the same measures plus additional questions to explore adherence, benefits and problems with glove-wear. A sub-sample of participants from each group will be interviewed at the end of their participation to explore their views of the gloves received. The clinical effectiveness and cost-effectiveness of the intervention, compared to placebo gloves, will be evaluated over 12 weeks. The primary outcome measure is Hand Pain during activity. Qualitative interviews will be thematically analysed. This study will evaluate the commonest type of arthritis glove (Isotoner) provided in the NHS (i.e. the intervention) compared to a placebo glove. The results will help occupational therapists, occupational therapy services and people with arthritis make informed choices as to the value of arthritis gloves. If effective, arthritis gloves should become more widely available in the NHS to help people with RA and IA manage Hand symptoms and improve performance of daily activities, work and leisure. If not, services can determine whether to cease supplying these to reduce service costs. ISRCTN Registry: ISRCTN25892131 Registered 05/09/2016
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Hand Pains in women and men in early rheumatoid arthritis, a one year follow-up after diagnosis. The Swedish TIRA project.
Disability and rehabilitation, 2016Co-Authors: Ingrid Thyberg, Örjan Dahlström, Mathilda Björk, Birgitta Stenström, Jo AdamsAbstract:Purpose This research analysed general Pain intensity, Hand Pain at rest and Hand Pain during activity in women and men in early rheumatoid arhtritis (RA). Method Out of the 454 patients that were recruited into the Swedish early RA project "TIRA" the 373 patients (67% women) that remained at 12 months follow-up are reported here. Disease activity 28 joint score (DAS-28), disability (Health Assessment Questionnaire = HAQ) and Pain (VAS) were recorded at inclusion and after 3 (M3), 6 (M6) and 12 (M12) months. General Pain, Hand Pain during rest, Hand Pain during test of grip force as assessed by Grippit™, prescribed disease-modifying anti-inflammatory drugs (DMARDs) and Hand dominance were recorded. Results DAS-28 and HAQ scores were high at inclusion and improved thereafter in both women and men. There were no significant differences between sexes at inclusion but women had higher DAS-28 and HAQ at all follow-ups. Women were more often prescribed DMARDs than were men. In both women and men all Pain types were significantly lower at follow-up compared to at inclusion and women reported higher Pain than men at follow-ups. The Pain types differed significantly from each other at inclusion into TIRA, general Pain was highest and Hand Pain during rest was lowest. There were no significant differences in Hand Pain related to Hand dominance or between right and left Hands. Conclusions Disease activity, disability and Pain were high at inclusion and reduced over the first year. Despite more DMARDs prescribed in women than in men, women were more affected than were men. General Pain was highest and not surprisingly Hand Pain during active grip testing was higher than Hand Pain during rest that was lowest in both sexes. Although our cohort was well controlled, it was evident that Hand Pain remains a problem. This has implications for rehabilitation and suggests potential ongoing activity limitations that should continue to receive attention from a multi-professional team. Implications for Rehabilitation General Pain and Hand Pain remain a problem in RA despite today's early intervention and effective disease control with new era biologics. The extent of Hand Pain evidenced in our work gives a more detailed and comprehensive account of Pain status. Higher Hand Pain during active grip testing than that during rest indicates a potential relationship to ongoing activity limitation. Hand Pain assessment can help guiding multi-professional interventions directed to reduce Hand Pain and thereby probably reduce activity limitations.
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Hand Pains and general Pain in women and men in early RA: A one year follow up after diagnosis in the TIRA-2 cohort
Annals of the Rheumatic Diseases, 2013Co-Authors: Ingrid Thyberg, Örjan Dahlström, Mathilda Björk, Birgitta Stenström, Jo AdamsAbstract:Background Pain in Rheumatoid arthritis (RA) is more prevalent in women than men. Hand involvement in RA is associated with Hand Pain, low grip force and reduced grip ability. Hand Pain related to Hand activity and possible differences between sexes have not yet been reported in early RA. Objectives To analyze Hand Pain during activity, Hand Pain at rest and general Pain during the first year of RA for women and men. Methods 454 patients were recruited into the Swedish early RA project “TIRA” during 2006-2009. The 373 patients (67 % women) that remained at 12 months follow up are reported here. Data for disease activity (DAS-28), general Pain (VAS), Hand Pain during rest (VAS) and Hand Pain during activity (VAS) was registered at inclusion and at the follow-ups after 3 (M3), 6 (M6), and 12 (M12) months respectively. Hand Pain during activity was related to test of grip force as measured by Grippita. Prescribed disease-modifying anti-inflammatory drugs (DMARDs) and Hand dominance was registered. Differences in mean values were analysed using ANOVA and differences in medication were analysed using chi-square tests. Results Women had slightly higher proportions of DMARDs than men throughout the study (84% to 93 % vs 75% to 92%) although the differences were significant only at M3 (p=.022; 85% vs 75%). Disease activity was high at inclusion (mean=5.12) and decreased significantly (p Conclusions Women had higher DAS and Pain than men despite somewhat more women than men prescribed DMARD:s. Hand Pain in activity was higher than Pain during rest, strongly indicating that Hand Pain is closely related to performing Hand activities in general in early RA. Disclosure of Interest None Declared
Bart W Koes - One of the best experts on this subject based on the ideXlab platform.
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prevalence and pattern of radiographic Hand osteoarthritis and association with Pain and disability the rotterdam study
Annals of the Rheumatic Diseases, 2005Co-Authors: S Dahaghin, S M Biermazeinstra, H A P Pols, Johanna M W Hazes, Abida Z Ginai, Bart W KoesAbstract:Objective: To investigate the prevalence and pattern of radiographic osteoarthritis (ROA) of the Hand joints and its association with self reported Hand Pain and disability. Methods: Baseline data on a population based study (age ⩾55 years) were used (n = 3906). Hand ROA was defined as the presence of Kellgren–Lawrence grade ⩾2 radiological changes in two of three groups of Hand joints in each Hand. The presence of Hand Pain during the previous month was defined as Hand Pain. The health assessment questionnaire was used to measure Hand disability. Results: 67% of the women and 54.8% of the men had ROA in at least one Hand joint. DIP joints were affected in 47.3% of participants, thumb base in 35.8%, PIP joints in 18.2%, and MCP joints in 8.2% (right or left Hand). ROA of other joint groups (right Hand) co-occurred in 56% of DIP involvement, 88% of PIP involvement, 86% of MCP involvement, and 65% of thumb base involvement. Hand Pain showed an odds ratio of 1.9 (1.5 to 2.4) with the ROA of the Hand (right). Hand disability showed an odds ratio of 1.5 (1.1 to 2.1) with ROA of the Hand (right or left). Conclusions: Hand ROA is common in the elderly, especially in women. Co-occurrence of ROA in different joint groups of the Hand is more common than single joint disease. There is a modest to weak association between ROA of the Hand and Hand Pain/disability, varying with the site of involvement.
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prevalence and determinants of one month Hand Pain and Hand related disability in the elderly rotterdam study
Annals of the Rheumatic Diseases, 2005Co-Authors: S Dahaghin, S M Biermazeinstra, Max Reijman, H A P Pols, Johanna M W Hazes, Bart W KoesAbstract:Objective: To study the prevalence of Hand Pain and Hand disability in an open population, and the contribution of their potential determinants. Methods: Baseline data were used from 7983 participants in the Rotterdam study (a population based study in people aged ⩾55 years). A home interview was used to determine the presence of Hand Pain during the previous month, rheumatoid arthritis, osteoarthritis in any joint, diabetes, stroke, thyroid disease, neck/shoulder Pain, gout, history of fracture in the past five years, and Parkinson’s disease, as well as age, sex, and occupation. Hand disability was defined as the mean score of eight questions related to Hand function. Body mass index was measured and Hand x rays were taken. Results: The one month period prevalence of Hand Pain was 16.9%. The prevalence of Hand disability was 13.6%. In univariate analysis for Hand Pain, rheumatoid arthritis had the highest explained variance ( R 2 ) and odds ratio. For Hand disability, aging showed the highest explained variance and Parkinson’s disease had the highest odds ratio. All determinants together showed an explained variance of 19.8% for Hand Pain and 25.2% for Hand disability. In multivariate analysis, positive radiographic Hand osteoarthritis was a poor explanation for Hand Pain ( R 2 = 0.5%) or Hand disability ( R 2 = 0). Conclusions: The contribution of available potential determinants in this study was about 20% for Hand Pain and 25% for Hand disability in an unselected population of elderly people. Thus a greater part of Hand Pain/Hand disability remains unexplained.
Johan H. Andersen - One of the best experts on this subject based on the ideXlab platform.
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Risk factors for persistent elbow, forearm and Hand Pain among computer workers
Scandinavian Journal of Work Environment and Health, 2005Co-Authors: Christina Funch Lassen, Sigurd Mikkelsen, Ann Isabel Kryger, Johan H. AndersenAbstract:OBJECTIVES: This study examined the influence of work-related and personal factors on the prognosis of "severe" elbow, forearm, and wrist-Hand Pain among computer users. METHODS: In a 1-year follow-up study of 6943 computer users, 673 (10%) participants reported "quite a lot" or more trouble due to elbow, forearm, or wrist-Hand Pain during the 12 months preceding the baseline questionnaire. Pain status (recovery versus persistence) at follow-up was examined in relation to computer work aspects and ergonomic, psychosocial, and personal factors by questionnaire. In addition, data on objectively recorded computer usage were available for 42% of the participants during the follow-up, measured by means of a program (WorkPaceRecorder) installed on their computers. RESULTS: During the follow-up, two-thirds of the baseline cases improved to some degree, but only one-third experienced substantial improvement. The prognosis was not influenced by mouse or keyboard work (time, speed, micropauses, and average activity periods) or ergonomic workplace conditions. Keyboard times, however, were very low. Pain in other regions was a predictor of persistent arm Pain. Except for time pressure, female gender, and type-A behavior, the prognosis seemed independent of psychosocial workplace factors and personal factors. A few cases with severe Pain were affected at a level which could be compared to clinical Pain conditions. CONCLUSIONS: Our results do not support the hypothesis that computer work activity or ergonomic conditions influence the prognosis of severe arm Pain. This result is somewhat surprising and should be tested in other studies. Pain in other regions implies a poorer prognosis for arm Pain.
Jesús Sanz - One of the best experts on this subject based on the ideXlab platform.
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Hand Pain other than carpal tunnel syndrome (CTS): the role of occupational factors.
Best practice & research. Clinical rheumatology, 2011Co-Authors: José Luis Andreu, Teresa Otón, Lucía Silva-fernández, Jesús SanzAbstract:Some occupational factors have been implicated in the development of disorders manifested as Hand Pain. The associations seem to be well documented in processes such as Hand-arm vibration syndrome (HAVS) or writer's cramp. There are contradictory data in the literature about the relationships of trigger finger, De Quervain's tenosynovitis (DQT) and tenosynovitis of the wrist with occupational factors. In this article, we review current knowledge about clinical manifestations, case definition, implicated occupational factors, diagnosis and treatment of the most relevant Hand Pain disorders that have been associated with occupational factors, excluding carpal tunnel syndrome (CTS).
S Dahaghin - One of the best experts on this subject based on the ideXlab platform.
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prevalence and pattern of radiographic Hand osteoarthritis and association with Pain and disability the rotterdam study
Annals of the Rheumatic Diseases, 2005Co-Authors: S Dahaghin, S M Biermazeinstra, H A P Pols, Johanna M W Hazes, Abida Z Ginai, Bart W KoesAbstract:Objective: To investigate the prevalence and pattern of radiographic osteoarthritis (ROA) of the Hand joints and its association with self reported Hand Pain and disability. Methods: Baseline data on a population based study (age ⩾55 years) were used (n = 3906). Hand ROA was defined as the presence of Kellgren–Lawrence grade ⩾2 radiological changes in two of three groups of Hand joints in each Hand. The presence of Hand Pain during the previous month was defined as Hand Pain. The health assessment questionnaire was used to measure Hand disability. Results: 67% of the women and 54.8% of the men had ROA in at least one Hand joint. DIP joints were affected in 47.3% of participants, thumb base in 35.8%, PIP joints in 18.2%, and MCP joints in 8.2% (right or left Hand). ROA of other joint groups (right Hand) co-occurred in 56% of DIP involvement, 88% of PIP involvement, 86% of MCP involvement, and 65% of thumb base involvement. Hand Pain showed an odds ratio of 1.9 (1.5 to 2.4) with the ROA of the Hand (right). Hand disability showed an odds ratio of 1.5 (1.1 to 2.1) with ROA of the Hand (right or left). Conclusions: Hand ROA is common in the elderly, especially in women. Co-occurrence of ROA in different joint groups of the Hand is more common than single joint disease. There is a modest to weak association between ROA of the Hand and Hand Pain/disability, varying with the site of involvement.
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prevalence and determinants of one month Hand Pain and Hand related disability in the elderly rotterdam study
Annals of the Rheumatic Diseases, 2005Co-Authors: S Dahaghin, S M Biermazeinstra, Max Reijman, H A P Pols, Johanna M W Hazes, Bart W KoesAbstract:Objective: To study the prevalence of Hand Pain and Hand disability in an open population, and the contribution of their potential determinants. Methods: Baseline data were used from 7983 participants in the Rotterdam study (a population based study in people aged ⩾55 years). A home interview was used to determine the presence of Hand Pain during the previous month, rheumatoid arthritis, osteoarthritis in any joint, diabetes, stroke, thyroid disease, neck/shoulder Pain, gout, history of fracture in the past five years, and Parkinson’s disease, as well as age, sex, and occupation. Hand disability was defined as the mean score of eight questions related to Hand function. Body mass index was measured and Hand x rays were taken. Results: The one month period prevalence of Hand Pain was 16.9%. The prevalence of Hand disability was 13.6%. In univariate analysis for Hand Pain, rheumatoid arthritis had the highest explained variance ( R 2 ) and odds ratio. For Hand disability, aging showed the highest explained variance and Parkinson’s disease had the highest odds ratio. All determinants together showed an explained variance of 19.8% for Hand Pain and 25.2% for Hand disability. In multivariate analysis, positive radiographic Hand osteoarthritis was a poor explanation for Hand Pain ( R 2 = 0.5%) or Hand disability ( R 2 = 0). Conclusions: The contribution of available potential determinants in this study was about 20% for Hand Pain and 25% for Hand disability in an unselected population of elderly people. Thus a greater part of Hand Pain/Hand disability remains unexplained.
