The effectiveness of a splint programme in preventing the deterioration of already evident swan neck and boutonniere deformities in patients with rheumatoid arthritis

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dc.contributor.advisorWatson, Ruth Wen_ZA
dc.contributor.authorDu Toit, Alida Christinaen_ZA
dc.date.accessioned2017-12-14T09:33:00Z
dc.date.available2017-12-14T09:33:00Z
dc.date.issued1991en_ZA
dc.description.abstractThe aim of this study was to establish whether a splint programme is effective in preventing the deterioration of already evident swan neck and boutonniere deformities in rheumatoid arthritis (RA). A randomised clinical trial was done on 34 RA patients with swan neck and 34 RA patients with boutonniere deformities. The literature revealed that several factors such as age, gender, socio-economic status, time after onset of the illness and lifestyle could influence results. Care was taken to allocate, as far as possible equal numbers of patients with these attributes to the experimental and control groups. It became clear from the literature that swan neck and boutonniere deformities could manifest themselves in different forms and stages or grades of deterioration. Various splints to halt the downward spiral of the deformity were recommended, without proper scientific verification, by the authors. No specifications as to which splint was recommended for which form or grade of deformity or instructions for wearing of the splints were included. For the study the PIP hyperextension splint and the three-point-PIP extension splint was chosen for the swan neck and boutonniere deformities respectively. Patients were followed up for one year. Results were marginally positive for the prevent ion of swan neck deformities by the hyperextension splint programme, but results for the three-point PIP extension splint programmes were negative for grade I boutonniere deformities. Loss of flexor muscle strength was evident in almost all the groups (experimental and control) but more so for grade I swan neck and grade I boutonniere deformities. The variability of measurements were found to be large. Many possible sources of variation were identified, which included biological differences between people, different courses the illness could take and a weak test-retest reliability of some goniometer measurements. This fact and the relatively small sample subgroups caused some results to be not significant on the 5% level. From the significant findings, and other not significant tendencies that were too persistent to ignore, linked to the different manifestations and grades of swan neck and boutonniere deformities, recommendations were made. These suggestions will have to be tested by experimentation.en_ZA
dc.identifier.apacitationDu Toit, A. C. (1991). <i>The effectiveness of a splint programme in preventing the deterioration of already evident swan neck and boutonniere deformities in patients with rheumatoid arthritis</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy. Retrieved from http://hdl.handle.net/11427/26623en_ZA
dc.identifier.chicagocitationDu Toit, Alida Christina. <i>"The effectiveness of a splint programme in preventing the deterioration of already evident swan neck and boutonniere deformities in patients with rheumatoid arthritis."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy, 1991. http://hdl.handle.net/11427/26623en_ZA
dc.identifier.citationDu Toit, A. 1991. The effectiveness of a splint programme in preventing the deterioration of already evident swan neck and boutonniere deformities in patients with rheumatoid arthritis. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Du Toit, Alida Christina AB - The aim of this study was to establish whether a splint programme is effective in preventing the deterioration of already evident swan neck and boutonniere deformities in rheumatoid arthritis (RA). A randomised clinical trial was done on 34 RA patients with swan neck and 34 RA patients with boutonniere deformities. The literature revealed that several factors such as age, gender, socio-economic status, time after onset of the illness and lifestyle could influence results. Care was taken to allocate, as far as possible equal numbers of patients with these attributes to the experimental and control groups. It became clear from the literature that swan neck and boutonniere deformities could manifest themselves in different forms and stages or grades of deterioration. Various splints to halt the downward spiral of the deformity were recommended, without proper scientific verification, by the authors. No specifications as to which splint was recommended for which form or grade of deformity or instructions for wearing of the splints were included. For the study the PIP hyperextension splint and the three-point-PIP extension splint was chosen for the swan neck and boutonniere deformities respectively. Patients were followed up for one year. Results were marginally positive for the prevent ion of swan neck deformities by the hyperextension splint programme, but results for the three-point PIP extension splint programmes were negative for grade I boutonniere deformities. Loss of flexor muscle strength was evident in almost all the groups (experimental and control) but more so for grade I swan neck and grade I boutonniere deformities. The variability of measurements were found to be large. Many possible sources of variation were identified, which included biological differences between people, different courses the illness could take and a weak test-retest reliability of some goniometer measurements. This fact and the relatively small sample subgroups caused some results to be not significant on the 5% level. From the significant findings, and other not significant tendencies that were too persistent to ignore, linked to the different manifestations and grades of swan neck and boutonniere deformities, recommendations were made. These suggestions will have to be tested by experimentation. DA - 1991 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 1991 T1 - The effectiveness of a splint programme in preventing the deterioration of already evident swan neck and boutonniere deformities in patients with rheumatoid arthritis TI - The effectiveness of a splint programme in preventing the deterioration of already evident swan neck and boutonniere deformities in patients with rheumatoid arthritis UR - http://hdl.handle.net/11427/26623 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/26623
dc.identifier.vancouvercitationDu Toit AC. The effectiveness of a splint programme in preventing the deterioration of already evident swan neck and boutonniere deformities in patients with rheumatoid arthritis. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy, 1991 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/26623en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Occupational Therapyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherAbnormalities - rehabilitationen_ZA
dc.subject.otherArthritis, Rheumatoid - Therapyen_ZA
dc.subject.otherArthritis, Rheumatoid - rehabilitationen_ZA
dc.subject.otherOccupational Therapy - methodsen_ZA
dc.subject.otherSplints - utilizationen_ZA
dc.titleThe effectiveness of a splint programme in preventing the deterioration of already evident swan neck and boutonniere deformities in patients with rheumatoid arthritisen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMSc (Med)en_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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