Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Oct 7;2009(4):CD006729.
doi: 10.1002/14651858.CD006729.pub2.

Assistive technology for rheumatoid arthritis

Hanne Tuntland  1 , Ingvild Kjeken, Lena V Nordheim, Louise Falzon, Gro Jamtvedt, Kåre Birger Hagen
Affiliations

Assistive technology for rheumatoid arthritis

Hanne Tuntland et al. Cochrane Database Syst Rev. .

Abstract

Background: Provision of assistive technology is a widely used intervention for people with rheumatoid arthritis. Assistive technology is any item used to increase or maintain functional ability in individuals with disabilities. It includes a wide range of products, from low-technology devices to technologically complex equipment. Yet, there are few systematic reviews on the effectiveness of assistive technology in this population.

Objectives: To assess the benefits of assistive technology for adults with rheumatoid arthritis in terms of improving functional ability and reducing pain, and to assess potential adverse effects in terms of psychological discomfort, personal injury or material damage related to device use.

Search strategy: We searched the following databases: CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CINAHL, AMED, ISI Web of Science, PEDro, and OTseeker (to October 2008). In addition, we scanned reference lists, sought grey literature, and had personally communicated with authors. We updated the literature searches in January 2009.

Selection criteria: Included study designs were randomised controlled trials, clinical controlled trials, controlled before and after studies, and interrupted time series where the effectiveness of assistive technology was evaluated. In addition, comparative observational studies were included if addressing adverse effects.

Data collection and analysis: Two authors independently selected trials, extracted data, and assessed study quality. Investigators were contacted to obtain missing information.

Main results: Only one randomised controlled trial with 29 participants was included. The study compared the use of an eye drop device to a standard bottle in people with rheumatoid arthritis suffering from persistent dry eyes. The study was considered to have low quality of evidence. The proportions with observed difficulties when using the device to squeeze out drops and getting the drops in the eyes were 10% and 14%, respectively. This compared to 52% and 52% when using the standard bottle (P = 0.001; P = 0.003, respectively). The proportions of participants reporting difficulties with squeezing the bottle, controlling the number of drops, and aiming the drops when using the device were 40%, 44%, and 46% respectively, while using the standard bottle the proportions with difficulties were 72%, 84%, and 76% (P = 0.001; P = 0.003; P = 0.031, respectively).

Authors' conclusions: Only one trial met the inclusion criteria for this review. Thus, there is very limited evidence for the effect of assistive technology for adults with rheumatoid arthritis and, therefore, an urgent need for high-quality research addressing the effectiveness of commonly used interventions.

PubMed Disclaimer

Conflict of interest statement

There are no known potential conflicts of interest.

Update of

References

References to studies included in this review

Averns 1999 {published and unpublished data}
    1. Averns H, Hall J, Webley M. Role of Opticare eye drop delivery system in patients with rheumatoid arthritis. The Journal of Rheumatology 1999;26(12):2615‐8. [MEDLINE: ] - PubMed

References to studies excluded from this review

Galumbeck 2004 {published data only}
    1. Galumbeck MH, Buschbacher RM, Wilder RP, Winters KL, Hudson MA, Edlich RF. The Sit & Stand chair. A revolutionary advance in adaptive seating systems. Journal of Long‐Term Effects of Medical Implants 2004;14(6):535‐43. [MEDLINE: ] - PubMed
Hass 1997 {published data only}
    1. Hass U, Brodin H, Andersson A, Persson J. Assistive technology selection: a study of participation of users with rheumatoid arthritis. IEEE Transactions on Rehabilitation Engineering 1997;5(3):263‐75. [MEDLINE: ] - PubMed
Hoenig 2007 {published data only}
    1. Hoenig H, Pieper C, Branch LG, Cohen HJ. Effect of motorized scooters on physical performance and mobility: a randomized clinical trial. Archives of Physical Medicine and Rehabilitation 2007;88(3):279‐86. [MEDLINE: ] - PubMed
Löfkvist 1988 {published data only}
    1. Löfkvist UB, Brattström M, Geborek P, Lidgren L. Individually adapted lightweight walking aids with moulded handles for patients with severely deforming chronic arthritis. Scandinavian Journal of Rheumatology 1988;17:167‐73. - PubMed
Munro 1998 {published data only}
    1. Munro BJ, Steele JR, Bashford GM, Ryan M, Britten N. A kinematic and kinetic analysis of the sit‐to‐stand transfer using an ejector chair: implications for elderly rheumatoid arthritic patients. Journal of Biomechanics 1998;31(3):263‐71. [MEDLINE: ] - PubMed
Munro 2000 {published data only}
    1. Munro BJ, Steele JR. Does using an ejector chair affect muscle activation patterns in rheumatoid arthritic patients? A preliminary investigation. Journal of Electromyography and Kinesiology 2000;10(1):25‐32. [MEDLINE: ] - PubMed
Nordenskiold 1994 {published data only}
    1. Nordenskiold U. Evaluation of assistive devices after a course in joint protection. International Journal of Technology Assessment in Health Care 1994;10(2):293‐304. [MEDLINE: ] - PubMed
Nordenskiold 1996 {published data only}
    1. Nordenskiold U, Grimby G, Hedberg M, Wright B, Linacre JM. The structure of an instrument for assessing the effects of assistive devices and altered working methods in women with rheumatoid arthritis. Arthritis Care and Research 1996;9(5):358‐67. [MEDLINE: ] - PubMed
Nordenskiold 1998 {published data only}
    1. Nordenskiold U, Grimby G, Dahlin‐Ivanoff S. Questionnaire to evaluate the effects of assistive devices and altered working methods in women with rheumatoid arthritis. Clinical Rheumatology 1998;17(1):6‐16. [MEDLINE: ] - PubMed
Price 2003 {published data only}
    1. Price P, Rees‐Mathews S, Tebble N. The use of a new overlay mattress in patients with chronic pain: impact on sleep and self‐reported pain. Clinical Rehabilitation 2003;17:488‐92. - PubMed
Thyberg 2004 {published data only}
    1. Thyberg I, Hass UAM, Nordenskiold U, Skogh T. Survey of the use and effect of assistive devices in patients with early rheumatoid arthritis: a two‐year follow up of women and men. Arthritis and Rheumatism 2004;51(3):413‐21. [MEDLINE: ] - PubMed
Torrens 2000 {published data only}
    1. Torrens GE, Hann J, Webley M, Joy J, Sutherland IA. Hand performance assessment of ten people with rheumatoid arthritis when using a range of specified saucepans. Disability and Rehabilitation 2000;22(3):123‐34. [MEDLINE: ] - PubMed

Additional references

Altman 2001
    1. Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D. The revised CONSORT statement for reporting of randomized trials: Explanation and elaboration. Annals of Internal Medicine 2001;134(8):663‐94. - PubMed
Ass. Tech. Act 2004
    1. Assistive technology Act of 2004. Sec. 2 amendment to the assistive technology act of 1998. One Hundred and Eighth Congress of the United States of America.
Backman 2004
    1. Backman CL, Kennedy SM, Chalmers A, Singer J. Participation in paid and unpaid work by adults with rheumatoid arthritis. The Journal of Rheumatology 2004;31(1):47‐56. - PubMed
Cieza 2005
    1. Cieza A, Geyh S, Chatterji S, Kostanjsek N, Üstün B, Stucki G. ICF linking rules: An update based on lessons learned. Journal of Rehabilitation Medicine 2005;37(4):212‐8. - PubMed
Clegg 1997
    1. Clegg A, Bannigan K. Shifting the balance of opinion: RCTs in occupational therapy. British Journal of Occupational Therapy 1997;60(11):510‐2.
Coenen 2006
    1. Coenen M, Cieza A, Stamm TA, Amann E, Kollerits B, Stucki G. Validation of the international classification of functioning, disability and health (ICF) core sets for rheumatoid arthritis from the patient perspective using focus groups. Arthritis Research & Therapy 2006;8(4):R84. - PMC - PubMed
de Jonge 2007
    1. Jonge D, Scherer MJ, Rodger S. Assistive technology in the workplace. St. Louis, Missouri: Mosby Elsevier, 2007.
Dijcks 2006
    1. Dijcks BPJ, Witte LP, Gelderblom GJ, Wessels RD, Soede M. Non‐use of assistive technology in The Netherlands: A non‐issue?. Disability and Rehabilitation: Assistive Technology 2006;1:97‐102. - PubMed
Egan 2001
    1. Egan M, Brosseau L, Farmer M, Ouimet M, Rees S, Tugwell P, et al. Splints and Orthoses for treating rheumatoid arthritis (Review). Cochrane Database of Systematic Reviews 2001, Issue 4. [DOI: 10.1002/14651858.CD004018] - DOI - PMC - PubMed
Fex 1998
    1. Fex E, Larsson BM, Nived K, Eberhardt K. Effect of rheumatoid arthritis on work status and social and leisure time activities in patients followed 8 years from onset. The Journal of Rheumatology 1998;25(1):44‐50. - PubMed
Fries 1980
    1. Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis and Rheumatism 1980;23:137‐45. - PubMed
Fuhrer 2001
    1. Fuhrer, M. Assistive technology outcomes research: Challenges met and yet unmet. American Journal of Physical Medicine & Rehabilitation 2001;80(7):528‐35. - PubMed
Glasziou 2007
    1. Glasziou P, Chalmers I, Rawlins M, McCulluch P. When are randomised trials unnecessary? Picking signal from noise. BMJ 2007;334 (7589):349‐51. [DOI: 10.1136/bmj.39070.527986.68] - DOI - PMC - PubMed
Guyatt 1990
    1. Guyatt GH, Keller JL, Jaeschke R, Rosenbloom D, Adachi JD, Newhouse MT. The n‐of‐1 randomized controlled trial: Clinical usefulness. Our three‐year experience. Annals of Internal Medicine 1990;112(4):293‐9. - PubMed
Hammond 1998
    1. Hammond A. The use of self‐management strategies by people with rheumatoid arthritis. Clinical Rehabilitation 1998;12(1):81‐7. - PubMed
Hammond 2004
    1. Hammond A. What is the role of the occupational therapist?. Best Practice & Research. Clinical Rheumatology 2004;18(4):491‐505. - PubMed
Haworth 1983
    1. Haworth RJ. Use of aids during the first three months after total hip replacement. British Journal of Rheumatology 1983;22(1):29‐35. - PubMed
Higgins 2008
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.1 (updated September 2008). Chichester, UK: John Wiley & Sons, Ltd, 2008.
Ilott 2006
    1. Ilott I, Taylor MC, Bolanos C. Evidence‐based occupational therapy: It's time to take a global approach. British Journal of Occupational Therapy 2006;69(1):38‐41.
ISO 9999:2007
    1. ISO 9999:2007. Assistive products for persons with disability ‐ Classification and terminology. Fourth. American National Standards Institute, 2007.
Ivanoff 2006
    1. Ivanoff SD, Iwarsson S, Sonn U. Occupational therapy research on assistive technology and physical environmental issues: A literature review. Canadian Journal of Occupational Therapy 2006;73(2):109‐19. - PubMed
Jeffrey 2005
    1. Jeffrey J, Fuhrer MJ, Demers L, Scherer MJ, DeReyter F. Toward a taxonomy of assistive device technology. American Journal of Physical Medicine & Rehabilitation 2005;84(4):294‐302. - PubMed
Jolles 2005
    1. Jolles BM, Buchbinder R, Beaton DE. A study compared nine patient‐specific indices for musculoskeletal disorders. Journal of Clinical Epidemiology 2005;58(8):791‐801. - PubMed
Kloppenburg 2007
    1. Kloppenburg M, Stamm T, Watt I, Kainberger F, Cawston TE, Birrel FN, et al. Research in hand osteoarthritis: Time for reappraisal and demand for new strategies. An opinion paper. Annals of Rheumatic Diseases 2007;66(9):1157‐61. - PMC - PubMed
Lenker 2005
    1. Lenker JA, Scherer MJ, Fuhrer MJ, Jutai JW, DeRuyter F. Psychometric and administrative properties of measures in assistive technology devices outcomes research. Assistive Technology 2005;17(1):7‐22. - PubMed
Levack 2006
    1. Levack WMM, Taylor K, Siegert RJ, Dean SG. Is goal planning in rehabilitation effective? A systematic review. Clinical Rehabilitation 2006;20:739‐55. - PubMed
Lovarini 2006
    1. Lovarini M, McCluskey A, Curtin M. Limited high‐quality research on the effectiveness of assistive technology. Australian Occupational Therapy Journal 2006;53(1):50.
Löfquist 2005
    1. Löfquist C, Nygren C, Szeman Z, Iwarsson S. Assistive devices among very old people in five European countries. Scandinavian Journal of Occupational Therapy 2005;12(4):181‐92. - PubMed
Malcus‐Johnson 2005
    1. Malcus‐Johnson P, Carlquist C, Sturesson AL, Eberhardt K. Occupational therapy during the first 10 years of rheumatoid arthritis. Scandinavian Journal of Occupational Therapy 2005;12:128‐35. - PubMed
Mann 1995
    1. Mann WC, Hurren D, Tomita M. Assistive devices used by home‐based elderly with rheumatoid arthritis. American Journal of Occupational Therapy 1995;49(8):810‐20. - PubMed
Maxwell 2006
    1. Maxwell L, Santesso N, Tugwell PS, Wells GA, Judd M, Buchbinder R, the Editorial Board of the Cochrane Musculoskeletal Group. Method guidelines for Cochrane Musculoskeletal Group systematic reviews. The Journal of Rheumatology 2006;33(11):2304‐11. - PubMed
McMillen 2002
    1. McMillen AM, Söderberg S. Disabled persons´ experience of dependence on assistive devices. Scandinavian Journal of Occupational Therapy 2002;9:176‐83.
Nordenskiöld 1997
    1. Nordenskiöld U. Daily activities in women with rheumatoid arthritis. Aspects of patient education, assistive devices and methods for disability and impairment assessment. Scandinavian Journal of Rehabilitation Medicine. Supplement 1997;37:1‐72. - PubMed
Philips 1993
    1. Philips B, Zhao H. Predictors of assistive technology abandonment. Assistive Technology 1993;5(1):36‐45. - PubMed
Rogers 1992
    1. Rogers JC, Holm MB. Assistive technology device use in patients with rheumatic disease: A literature review. American Journal of Occupational Therapy 1992;46(2):120‐7. - PubMed
Rogers 2002
    1. Rogers JC, Holm MB, Perkins L. Trajectory of assistive device usage and user and non‐user characteristics: Long‐handled bath sponge. Arthritis and Rheumatism 2002;47:645‐50. - PubMed
Scherer 2005
    1. Scherer MJ, Sax C, Vanbiervliet A, Cushman LA, Scherer JV. Predictors of assistive technology use: The importance of personal and psychological factors. Disability and Rehabilitation 2005;27(21):1321‐31. - PubMed
Shipham 2003
    1. Shipham I, Pitout SJ. Rheumatoid arthritis: Hand function, activities of daily living, grip strength and essential assistive devices. Curationis 2003;26(3):98‐106. - PubMed
Stamm 2004
    1. Stamm TA, Cieza A, Machold KP, Smolen JS, Stucki G. Content comparison of occupation‐based instruments in adult rheumatology and musculoskeletal rehabilitation based on the International Classification of Functioning, Disability and Health. Arthritis and Rheumatism 2004;51(6):917‐24. - PubMed
Steultjens 2004
    1. Steultjens EMJ, Dekker J, Bouter LM, Schaardenburg D, Kuyk MAH, Ende CHM. Occupational therapy for rheumatoid arthritis. Cochrane Database of Systematic Reviews 2004, Issue 1.. [DOI: 10.1002/14651858.CD003114.pub2] - DOI - PMC - PubMed
Straus 2005
    1. Straus S, Richardson WS, Glaziou P, Haynes BR. Evidence‐based medicine. How to practice and teach EBM. Third Edition. Elsevier Churchill Livingstone, 2005.
Stucki 2004
    1. Stucki G, Cieza A, Geyh S, Battistella L, Lloyd J, Symmons D, et al. ICF core sets for rheumatoid arthritis. Journal of Rehabilitation Medicine 2004;44 (suppl):87‐93. - PubMed
Stucki 2007
    1. Stucki G, Boonen A, Tugwell P, Cieza A, Boers M. The World Health Organisation International Classification of Functioning, Disability and Health: A conceptual model and interface for the OMERACT process. The Journal of Rheumatology 2007;34(3):600‐6. - PubMed
Uhlig 2005
    1. Uhlig T, Kvien TK. Is rheumatoid arthritis disappearing?. Annals of the Rheumatic Diseases 2005;64(1):7‐10. - PMC - PubMed
Van der 2003
    1. EM, Heijmans M, Dekker J. Factors contributing to possession and use of walking aids among persons with rheumatoid arthritis and osteoarthritis. Arthritis and Rheumatism 2003;15(49):838‐42. - PubMed
van der Heide 1993
    1. Heide A, Jacobs JW, Albada‐Kuipers GA, Kraaimaat FW, Geenen R, Bijlsma JW. Self report functional disability scores and the use of devices: Two distinct aspects of physical function in rheumatoid arthritis. Annals of the Rheumatic Diseases 1993;52(7):497‐502. - PMC - PubMed
van Kuyk‐Minis 1998
    1. Kuyk‐Minis MA. Assistive devices: integral to the daily living of human beings. Clinical Rheumatology 1998;17:3‐5. - PubMed
Veehof 2006
    1. Veehof MM, Taal E, Rasker JJ, Lohmann J, Laar MAFJ. What determines the possession of assistive devices among patients with rheumatic diseases? The influence of country‐related health‐care system. Disability and Rehabilitation 2006;28(4):205‐11. - PubMed
Veitiene 2005
    1. Veitiene D, Tamulaitiene M. Comparison of self‐management methods for osteoarthritis and rheumatoid arthritis. Journal of Rehabilitation Medicine 2005;37:58‐60. - PubMed
Vliet Vlieland 2002
    1. Vliet Vlieland TP. Care: International conference on multidisciplinary care in rheumatoid arthritis. International Journal of Advances in Rheumatology 2002;1:34‐6.
WHO 2001
    1. World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization, 2001.
Wieland 2006
    1. Wieland T. Home‐based training and the use of bathing devices increased usage and resulted in small improvements in personal independence and satisfaction for people with stroke. Australian Occupational Therapy Journal 2006;53:51‐2.
Wikström 2006
    1. Wikström I, Book C, Jacobsson LT. Difficulties in performing leisure activities among persons with newly diagnosed rheumatoid arthritis: A prospective controlled study. Rheumatology 2006;45(9):1162‐6. - PubMed
Wolfe 2000
    1. Wolfe T. Community resources and assistive devices for people with arthritis. Journal of Hand Therapy 2000;13(2):184‐92. - PubMed
Wressle 2004
    1. Wressle E, Samuelsson K. User satisfaction with mobility assistive devices. Scandinavian Journal of Occupational Therapy 2004;11:143‐50.

Publication types

Substances