Joint protection: Enabling change in musculoskeletal conditions multiple sclerosis

Abstract

Joint protection includes applying ergonomic principles in daily life, altering working methods, using assistive devices, and modifying environments. It is taught to people with musculoskeletal conditions, such as rheumatoid arthritis (RA), osteoarthritis, and soft tissue rheumatisms. Common principles are to distribute load over several joints, to reduce effort using assistive devices, to pace activities, to use orthoses, and to exercise regularly. Cognitive-behavioral, self-efficacy, and motor-learning approaches are employed. Trials demonstrate that using these approaches is significantly more effective than advice and demonstration alone in changing joint-protection behavior, improving function, and reducing pain in both early and established RA. When joint protection is combined with hand exercises, there is evidence that it improves grip strength in hand osteoarthritis, but there is still conflicting evidence for its effectiveness in soft-tissue rheumatisms. © Springer Science + Business Media, LLC 2009.