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Keywords:

  • Silver ring splint;
  • Rheumatoid arthritis;
  • Dexterity;
  • Hand function;
  • SODA

Abstract

Objective

To study the effect of Silver Ring Splints (SRSs) on hand function in patients with rheumatoid arthritis (RA).

Methods

RA patients with stable disease and finger deformities eligible for splinting received 1 or more SRSs. Primary outcome was dexterity, which was measured with the Sequential Occupational Dexterity Assessment (SODA). Secondary outcome measures were self-reported hand function (Dutch Arthritis Impact Measurement Scales 2), hand pain, grip and pinch strength, Disease Activity Score in 28 joints (DAS28), and patient satisfaction.

Results

Seventeen patients (median age 65 years; median disease duration 21 years) received a total of 72 SRSs. After 1 year, 48 SRSs were regularly used. Two patients dropped out because of adverse events related to SRSs. In the remaining 15 patients, SODA dexterity scores increased significantly (median 71 at baseline, 81 at 3 months, and 85 at 12 months), Wilcoxon signed ranks test P = 0.005 and P = 0.026. DAS28 scores did not change at 3 months and improved slightly after 12 months (–0.5; P = 0.019). Grip strength, self-reported hand function, and hand pain showed no significant changes. Eleven patients stated they would continue using their splints.

Conclusion

SRSs can improve dexterity in selected patients with rheumatoid hand deformities. For a satisfactory result, careful patient preassessment and optimal adjustment of SRSs are essential.