Therapeutic gloves for patients with arthritis

Therapeutic gloves are an intervention widely recommended and prescribed by rheumatologists and occupational therapists for the management and treatment of hand osteoarthritis (OA) and rheumatoid arthritis (RA). At least a dozen different models of therapeutic gloves are available, with varying design, construction and materials. However, there is no systematic classification for therapeutic gloves and their effectiveness has not been well established. In addition, little research has addressed the issue of material choice on glove performance. The aim of this research was to fill these knowledge gaps and establish a framework for the design and engineering of functional and comfortable therapeutic gloves. To achieve that aim, the author undertook a series of integrated theoretical, experiential, physical and mechanical investigations. The research began with a review of existing evidence about the effectiveness of therapeutic gloves for people with hand OA and RA. Then, 30 people with hand OA and RA were surveyed, using a purpose-designed questionnaire, to gain insights into their experiences and perceptions of currently available therapeutic gloves. Six commercially available therapeutic gloves were tested on three aspects: physical parameters, tensile attributes, and properties relevant to physiological comfort. The next stage of this research was a comprehensive investigation of the impact of hand movements on skin deformation and the resultant glove–skin interfacial pressure. The metacarpal region showed significantly higher skin deformation and glove–skin interfacial pressure than other regions. It was also found that the corresponding geometry and the curvature caused by hand movements impact the skin deformation and glove-skin interfacial pressures. The results were translated into regional hand mapping design concept. Individuals vary in their sensitivity towards different types of therapies, thus it is important in glove design to consider a range of levels of sensitivity towards pressure and thermal stimuli to improve wearer comfort and optimal therapy effectiveness. The pressure and thermal discomfort thresholds of 13 arthritis patients, recruited from local libraries, community centres, campuses of universities and local clinics were examined. Significant variations in pressure, cold and heat discomfort thresholds were found between patients, and sensitivities were significantly different at different locations of the hand. The results obtained were again translated into regional hand mapping design concept. The results from the literature review, survey study, objective material tests and physical testing were combined with the regional hand mapping design concept to produce a novel, evidence-based theoretical framework for the design and engineering of functional and comfortable therapeutic gloves. The methodologies employed and the framework established in this research significantly advance knowledge in this field, and provide a robust foundation for the design and engineering of therapeutic gloves and other user-centric therapeutic garments