The trial was conducted in rheumatology occupational therapy departments across 16 NHS sites in England and Scotland. Given that gloves are intended to be worn long term, a 12-week follow-up was selected to allow several weeks for glove tolerance to develop and for participants to experience the effects of regular wear for ≤2 months across a range of activities. Occupational therapists reviewed glove fit 2–4 weeks later or asked participants to contact them if experiencing problems. All received written information about hand self-management (joint protection and exercise). wearing gloves in the day, night or both). All participants received the same verbal and written information about glove wear and care, with the glove wear regimen individualized to suit their needs (i.e. Therapists attended theoretical and practical training in intervention and placebo glove fitting, in order to standardize treatment delivery. When fitting gloves, occupational therapists measured participants’ MCP joint circumference to determine the glove size required and used their clinical judgement to determine appropriate fit, following the A-GLOVES Occupational Therapy Glove Provision Manual. In the trial, they were fitted at least one size too large and exerted no or minimal pressure to ensure they did not apply therapeutic levels of compression. The placebo gloves for the control group were chosen by a panel of experts including occupational therapists, researchers and patient research partners to ensure their credibility. Participants in the control group received loose-fitting three-quarter-length finger Jobskin classic oedema gloves. Participants in the intervention group received correctly fitted three-quarter-length finger Isotoner gloves. We have previously reported results from a randomized controlled trial (RCT) in adults (≥18 years of age) with RA or UIA in the UK, investigating the clinical and cost-effectiveness of arthritis gloves compared with placebo gloves on hand pain, stiffness and function. Systematic review evidence was inconclusive about the effectiveness of arthritis gloves. Different makes of glove apply differing amounts of pressure. swelling), thus reducing pain and stiffness and improving finger movement. The mechanism by which arthritis gloves impact on hand symptoms is thought to be through compression, which removes extracellular fluid (e.g. Īrthritis gloves are widely prescribed in rheumatology departments by occupational therapists to people with RA and UIA presenting with hand pain and problems: for daytime wear to reduce hand pain and improve hand function and/or for night-time wear to reduce pain, improve sleep and reduce morning stiffness. These mechanisms might explain, in part, why a significant proportion of patients with RA remain symptomatic even with biological and targeted synthetic DMARDs (b/tsDMARDs). Like peripheral sensitization, central causes of pain arise as a result of abnormalities in the CNS and dysregulation of the CNS pain pathways, leading to chronic pain. Peripheral pain mechanisms include the direct activation of nociceptors, in addition to sensitization of nociceptors by joint inflammation. Knowledge and understanding of pain mechanisms in RA have since developed into describing this process as an interplay between joint pathology and the processing of pain signals by peripheral, spinal and supraspinal pain pathways. Pain from RA is historically thought to be a direct result of peripheral inflammation, but later studies have shown discordance between clinicians’ assessments of inflammation and patient-reported pain. DMARDs are also prescribed to those with persistent synovitis who have not yet met the diagnostic criteria for RA. These symptoms can persist and deteriorate even when disease activity is controlled with DMARDs, which are prescribed to achieve remission or lower disease activity and prevent radiographic progression of the disease. Nine out of 10 adults with RA report pain, stiffness, muscle weakness, paraesthesia and difficulty making a fist. Hand pain and functional problems are common and a leading cause of disabilities in everyday activities, leisure and work in people with RA.
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