Patients in Focus Award 2005
20/01/06 : Christina Macleod, OT, Therapy Services Department, Royal Hampshire County Hospital
The Innovative collaboration between rheumatology, occupational therapy services and a high street jeweller to produce finger orthotics as silver jewellery
History of Application
Jo Adams, the Lead Therapist in a project assessing the value of night resting splints in the South of England, has a lot of energy and charisma and through her encouragement and persuasion the application for the Patients in Focus Innovation Award was put together.
Background
Hand splints form a regular part of occupational therapy treatment for individuals with Rheumatoid Arthritis (RA). The splints are designed to decrease hand joint pain and swelling, improve joint stability and increase functional use of the hand. Frequently in RA a problem called ‘swan necking’ occurs. Swan necking is the bending of the top joint of the finger, with the next joint bending in the opposite direction than usual, making it difficult to make a fist and can occur in one or all of the fingers. Small finger splints are routinely made from thermoplastic to help support the joint and prevent further deformity.
Patients Feedback
Patients often report that the material used to make these splints is unsightly, sweaty and susceptible to breaking. People are reluctant to wear them. It is clear that an alternative should be offered.
Innovation and creativity
The consultant approached a local jeweller to see if these splints could be made in a local high street shop. Various techniques were tried by the jeweller before an acceptable design was established. Every patient has to pay for the splint themselves and the cost varies on the splint made All splints are individually measured and designed by the Occupational Therapist and Jeweller. Similar splints are manufactured in the USA and the Netherlands and can be purchased by mail order but using a local jeweller can generally ensure that the patient goes away with a splint that fits on the first day of fitting.
Patient Involvement
Informal patient feedback identified the need for a more attractive, comfortable and durable splint than those already available. Since then we have surveyed patients’ who have purchased the sliver ring splints for their opinions with questionnaires and audits. The comments include:
- Helps reduce the pain
- Brilliant Better than plastic
- Stopped the triggering completely
- Hands feel psychologically safer when wearing the splint –don’t worry about the deforming nature of the disease
- They are a good warning system if I am pushing my joint too far
- Able to bend my fingers better
- Fingers no longer collapse
- Even as a man who never wears jewellery the benefits out weight the negative
- Well worth trying
- People say how nice my hands look or “you’re cool”
- Would purchase them again
- Several people have asked about my knuckle dusters!!
A further study by the University of Southampton is planned on the biomechanical effects of these splints. How can you, as readers of this newsletter, find out more about these splints? You have to bear in mind that you will have to purchase these splints yourself. Your hospital may not have a friendly local jeweller who can help and so the splints will need to be ordered mail order. Your consultant should be able to refer you on to a therapist who can help or do contact NRAS who can put you in contact with some one to help.