Padilla, Byers- Connon, Lohman (2012) define Rheumatoid arthritis (RA) as a progressive autoimmune disease with onset in young adulthood or midlife. RA initially presents with inflammation and pain in the metacarpophalangeal and interphalangeal joints of the hands and eventually progresses to other organs. Signs and symptoms characteristic of RA include fatigue, loss of appetite, fever, deformities, overall achiness or stiffness that occurs on awakening, also indicates systemic involvement. The severity of the systemic symptoms usually matches the severity of joint involvement. As in many chronic diseases, a resulting depression or lack of motivation may also occur. In a small percentage of persons, the blood vessels, heart, lungs, or eyes may be involved. RA severely impairs functional performance and quality of life.
According to Early (2013) the hands are the sites most severely affected by RA. However joint changes and ...view middle of the document...
Hopefully it has been clearly demonstrated how RA can be debilitating and painful. It is the opinion of the author that RA can lead to social withdraw and a loss of occupation if symptoms go untreated. Treatment can consist of surgery, medication, and therapy. As a future occupational therapy assistant it will be my job to focus on the latter and help the client in their day to day activities and promote independence.
One treatment principle with RA is to deal with functional deficits caused by the disease. As listed above RA can lead to different types of deformities and complications of the patient’s joints. To correct deformities and promote joint stability of symptoms related to RA occupational therapy practitioners may craft splints which can also reduce inflammation associated with pain. Examples of splints include:
• Nighttime static, static-progressive, or dynamic extension splinting for elbow contractures.
• Resting hand splint (for night use)- maintains functional position, discourages ulnar drift, and provides rest to inflamed joints.
• Wrist cock-up splint- provides support to weakened or painful wrist during ADLs.
• Thumb spica splint- provides support to weakened or inflamed thumb CMC and MCP joints.
• Figure of eight splint- corrects swan neck deformities.
• Reverse knucklebender or spring finger extension- corrects boutonniere deformities.
• Ulnar deviation splint- prevents ulnar drift and encourages normal alignment of the MCP joints during pinch and grasp activities.