1. Effective treatments for restoring previous hand function of individuals with osteoarthritis Laura Mason, OTS Spalding University

2. WHY HAND OSTEOARTHRITIS? Cause Prevalence rate My level two experiences

3. PICO Question What are effective treatment(s) for restoring previous hand function of individuals with osteoarthritis?

4. Three prevalent treatment types: Paraffin bath Splinting Balneotherapy

5. Paraffin What is Paraffin? ◦ Paraffin is a hot wax that can reach temperatures of 126 degrees Fahrenheit without burning a client. ◦ Paraffin is great for scar breakdown since scar becomes pliable at 112 degrees Fahrenheit and moist heat packs only reach 110 degrees Fahrenheit. Implementation for Occupational Therapy: ◦ Paraffin can be used as a preparatory activity and then in the 15 minutes post treatment when pain is reduced range of motion with meaningful activities can be performed with less pain. ◦ Patient education on importance of owning a paraffin bath.

6. Splinting Implementation for Occupational Therapy: ◦ Splinting is a great tool for occupational therapist to place the hand in a functional position with decreased pain to promote functional activities. ◦ Patient education on where to buy prefabricated splints when custom splinting not available.

7. Balneotherapy What is balneotherapy? ◦ Balneotherapy involves hot or cold water, massage through moving water, relaxation or stimulation. These bathes include minerals such as sulfur which can be absorbed through the skin. Implementation for Occupational Therapy: ◦ Occupational therapist can use sulfurous bathes as an adjunct to therapy. While decreasing pain and inflammation prior to therapy patients can relax and fully participate in therapy sessions.

8. Other considerations TENSAquatic therapy Implementation for Occupational Therapy: ◦ Therapist can use TENS as an adjunct to therapy to decrease pain while performing ROM, and stress loading task. ◦ Patient education on home units. Implementation for Occupational therapy: ◦ Occupational therapist can use this information to create a well-designed aquatic, land- based exercise program, or home exercise program for patients with osteoarthritis, based on their preference and convenience.

9. References Horváth, K., Kulisch, Á., Németh, A., & Bender, T. (2012). Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study. Clinical Rehabilitation, 26(5), 431-441. doi:10.1177/0269215511425961 Kjeken, I., Darre, S., Slatkowsky-Cristensen, B., Hermann, M., Nilsen, T., Eriksen, C. S., & Nossum, R. (2013). Self-management strategies to support performance of daily activities in hand osteoarthritis. Scandinavian Journal Of Occupational Therapy, 20(1), 29-36. doi:10.3109/11038128.2012.661457 Kjeken, I., Darre, S., Smedslund, G., Hagen, K., & Nossum, R. (2011). Effect of assistive technology in hand osteoarthritis: a randomised controlled trial. Annals Of The Rheumatic Diseases, 70(8), 1447-1452. Kovács, C., Pecze, M., Tihanyi, Á., Kovács, L., Balogh, S., & Bender, T. (2012). The effect of sulphurous water in patients with osteoarthritis of hand. Double- blind, randomized, controlled follow-up study. Clinical Rheumatology, 31(10), 1437-1442. doi:10.1007/s10067-012-2026-0

10. References continued Myrer, J., Johnson, A., Mitchell, U. H., Measom, G. J., & Fellingham, G. W. (2011). Topical analgesic added to paraffin enhances paraffin bath treatment of individuals with hand osteoarthritis. Disability & Rehabilitation, 33(6), 467-474. doi:10.3109/09638288.2010.498552 Rakel, B. A., Blodgett, N. P., DeSantana, J., Amendola, A., Zimmerman, M., &... Sluka, K. A. (2012). Effects of transcutaneous electrical nerve stimulation on pain, pain sensitivity, and function in people with knee osteoarthritis: A randomized controlled trial. Physical Therapy, 92(7), 898-910. doi:http://dx.doi.org/10.2522/ptj.20110183 Sillem, H., Backman, C., Miller, W., & C, L. (2011). Comparison of two carpometacarpal stabilizing splints for individuals with thumb osteoarthritis. Journal of Hand Therapy, (195), doi: 24:216-26 Wang, T., Lee, S., Liang, S., Tung, H., Wu, S., & Lin, Y. (2011). Comparing the efficacy of aquatic exercises and land-based exercises for patients with knee osteoarthritis. Journal Of Clinical Nursing, 20(17/18), 2609-2622. doi:10.1111/j.1365-2702.2010.03675.x

11. Any Questions?