綜論類風濕性關節炎手部副木之臨床效益

Clinical Effectiveness of Hand Splints for Rheumatoid Arthritis: A Literature Review

劉倩秀(Chien-Hsiou Liu) ； 林靖麒(Jing-Chi Lin) ； 陳宏安(Hung-An Chen) ； 江心瑜(Hsin-Yu Chiang)

《職能治療學會雜誌》 28卷1期 (2010/01) Pp. 41-56

https://doi.org/10.6594/JTOTA.2010.28(1).04

摘要

類風濕性關節炎是嚴重影響個人生理功能、心理健康和生活品質之慢性發炎性關節疾病。根據調查，「提供副木」占職能治療師處理類風濕性關節炎所有介入手法之介入手法的第二位。本文回顧2002至2009年間之相關文獻，期以瞭解：(1)近年來相關研究在介入時間、量測內容和量測工具之現況；(2)目前臨床效益的量測內容是否包含國際健康功能與身心障礙分類系統所描述之所有層級；和(3)手部副木介入類風濕性關節炎患者手部問題之臨床效益。回顧結果指出，共有9篇類風濕性關節炎患者手部副木相關之實證研究，其中休息副木2篇，腕副木3篇，掌指屈曲阻擋副木1篇，銀戒副木2篇和功能性拇指副木1篇。回顧結果亦指出類風濕性關節炎患者使用副木之臨床效益，對於改善疼痛、肌力、精細動作表現和功能表現並無一致的結果。本文發現近期研究已探討介入時間對成效之影響和已選擇具備信度和效度之量測工具。本文亦建議未來研究能夠依國際健康功能與身心障礙分類系統陳述臨床效益，將「發病時間」列入收案標準，和將「使用性」列入臨床效益之影響因素。

關鍵字

類風濕性關節炎 ； 副木

並列摘要

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect an individual's physical function, mental health, and his/her quality of life. The results from previous studies indicated that ”providing splint” is the second most common treatment used by occupational therapists for individuals with RA. This paper aims to understand: 1) the current situation of intervening time and measurements of RA; 2) if the measurement tools measure the three domains of International Classification of Functioning, Disability, & Health (ICF); and 3) the clinical effectiveness of using splint for RA treatment. Reports from 2002 to 2009 were drawn for systematic review. Of the papers a total of nine papers were related to RA: two of them were related to resting splint; three were related to wrist splint; one was related to MP blocking splint; two were related to silver ring splint; and one was related to functional thumb splint. There was evidence demonstrated from the reports that the clinical effectiveness with respect to relief of pain, strength, dexterity, and functional performance of using splints on individuals with RA were not consistent. The results from this literature review found that the previous research had focused on exploring years of having RA disease duration as one of the participants' recruitment criteria and using standardized measurements with good validity and reliability. The future studies should focus on exploring the intervention time and its relationship to clinical effectiveness, using ICF as the conceptual framework, and including the ”usage” of splints as one of the factors affecting the clinical effectiveness of using splints for individuals with RA.

並列關鍵字

rheumatoid arthritis ； splint