Pain and Function: Occupational Therapists' Use of Orthotics in Rheumatoid Arthritis

Abstract

The use of orthotics in the management of rheumatoid arthritis appears to be relatively commonplace within occupational therapy departments. The aim of this study was to identify the frequency of orthotic use by occupational therapists, their beliefs about the efficacy of orthotic use, what they aimed to achieve by orthotic provision and any outcome measures used. The total membership of the British Association of Hand Therapists who were both occupational therapists and self-identified as working and/or having an interest in rheumatology (n = 132) were surveyed through a postal questionnaire. Of the responses received (n = 89, 67%), all the respondents (100%) were regular users of orthotics in the management of rheumatoid arthritis. The results showed that the most highly rated reasons for orthotic provision were to decrease hand and wrist pain and to improve hand function. Subjective comments from the respondents provided evidence of positive beliefs about the efficacy of orthotic use, despite a lack of objective outcome measures to support such comment. Given the complexity of the intervening variables that occur with orthotic use, perhaps there is no easy answer; however, with the expectation of evidence-based practice and intervention, it is suggested that an increased use of standardised outcome measures may provide additional strength in presenting, often subjective, evidence.