Background/Purpose: Wrist joints are frequently damaged by rheumatoid arthritis (RA). Wrist supports are often used to reduce pain and strain on wrists when patients with RA engage in hand-related activities, however, evidences for the efficacy of wrist supports are quite a few. Though wrist supports are made of either elastic or hard materials, elastic materials such as neoprene are preferred by patients with RA in Japan because wrist movement is tolerated. In this study, we investigated the efficacy of neoprene wrist supports on pain, hand function, activities of daily living (ADL), and instrumental activities of daily living (IADL) for patients with RA.

Methods: Patients with consistent wrist pain for at least a week and treated without changes of biologics or disease modifying antirheumatic drugs for at least 12 weeks were participated in this study. Patients with severe deformities of the fingers affecting hand function or a history of wrist surgery were excluded. Custom wrist supports (2mm thick, 8cm width, and 75cm length) are made of neoprene rubber laminated with knit fabric on both surfaces by occupational therapists (OT) to wrap three times on midcarpal joint, radiocarpal joint, and distal radioulnar joint. The participants were instructed to wear as long as possible when engaging in hand-related activities for 12 weeks. Wrist pain by 100mm visual analog scale (VAS), active range of motion (AROM) [dorsal, volar, pronation, and supination], grip strength, pinch strength (pulp pinch and key pinch), Disabilities of the Arm Shoulder and Hand (DASH), and Assessment of Motor and Process Skills (AMPS) were assessed at baseline, 1-2, 4, 8, and 12-week of wrist supports use. AROM, grip strength, and pinch strength were measured with or without wrist supports. The same AMPS task was performed for each evaluation. Data were analyzed with Wilcoxon signed rank test.

Results: Eight wrists of six female patients (age: 64.7±16.7 (33-79) years, disease duration: 15.2±9.9 (0.5-28) years, modified health assessment questionnaire (mHAQ) score: 1.6±0.4(1.13-2.25), Steinblocker’s class: II; 2 and III; 4, stage I; 1, IV; 5, Larsen’s classification of wrist: grade I; 1, II; 1, III; 2, IV; 4) were participated. Neoprene wrist supports significantly reduced wrist pain and improved ADL motor ability measures during the follow-up period. Grip strength was significantly increased only when wearing wrist supports. No significant changes were observed in AROM, DASH score, and key pinch strength.

Conclusion: Neoprene wrist supports reduce wrist pain, increase grip strength immediately, and improve ADL motor ability measures without limiting range of motion of wrist joints. Thus, neoprene wrist supports may be recommended for patients with RA when carrying out daily tasks.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/efficacy-of-neoprene-wrist-supports-for-patients-with-rheumatoid-arthritis/