Abstract
Objective
To evaluate the efficacy of paraffin bath therapy on pain, function, and muscle strength
in patients with hand osteoarthritis.
Design
Prospective single-blinded randomized controlled trial.
Setting
Department of physical medicine and rehabilitation in a university hospital.
Participants
Patients with bilateral hand osteoarthritis (N=56).
Interventions
Patients were randomized into 2 groups with a random number table by using block randomization
with 4 patients in a block. Group 1 (n=29) had paraffin bath therapy (5 times per
week, for 3-week duration) for both hands. Group 2 (n=27) was the control group. All
patients were informed about joint-protection techniques, and paracetamol intake was
recorded.
Main Outcome Measures
The primary outcome measures were pain (at last 48h) at rest and during activities
of daily living (ADL), assessed with a visual analog scale (0–10cm) at 12 weeks. The
secondary outcome measures were the Australian Canadian Osteoarthritis Hand Index
(AUSCAN) and the Dreiser Functional Index (DFI), used for subjective functional evaluation,
loss of range of motion (ROM), grip and pinch strength, painful and tender joint counts,
and paracetamol intake. A researcher blind to group allocation recorded the measures
for both hands at baseline, 3 weeks, and 12 weeks at the hospital setting.
Results
At baseline, there were no significant differences between groups in any of the parameters
(P>.05). After treatment, the paraffin group exhibited significant improvement in pain
at rest and during ADL, ROM of the right hand, and pain and stiffness dimensions of
the AUSCAN (P<.05). There was no significant improvement in functional dimension of the AUSCAN
and the DFI (P>.05). The control group showed a significant deterioration in right hand grip and
bilateral lateral pinch and right chuck pinch strength (P<.05), but there was no significant change in the other outcome measures. When the
2 groups were compared, pain at rest, both at 3 and 12 weeks, and the number of painful
and tender joints at 12 weeks significantly decreased in the paraffin group (P<.05). Bilateral hand-grip strength and the left lateral and chuck pinch strength
of the paraffin group were significantly higher than the control group at 12 weeks
(P<.05).
Conclusions
Paraffin bath therapy seemed to be effective both in reducing pain and tenderness
and maintaining muscle strength in hand osteoarthritis. It may be regarded as a beneficial
short-term therapy option, which is effective for a 12-week period.
Keywords
List of abbreviations:
ACR (American College of Rheumatology), ADL (activities of daily living), AUSCAN (Australian Canadian Osteoarthritis Hand Index), DFI (Dreiser Functional Index), EULAR (European League Against Rheumatism), RCT (randomized controlled trial), ROM (range of motion)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 26, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
