The Open Orthopaedics Journal

ISSN: 1874-3250 ― Volume 14, 2020

A Scoping Review of Joint Protection Programs for People with Hand Arthritis

Pavlos Bobos1, *, Goris Nazari1, Emily A Lalone2, Louis Ferreira2, Ruby Grewal3, Joy C MacDermid4
1 Western’s Bone and Joint Institute, Department of Health and Rehabilitation Sciences, Western University, 1151 Richmond Street, London, Ontario, Canada
2 Faculty of Engineering, Department of Mechanical and Materials Engineering, Western University, 1151 Richmond Street, Ontario, Canada
3 Western University, Roth | McFarlane Hand & Upper Limb Centre, St. Joseph's Health Care London, 268 Grosvenor St, London, Ontario, Canada
4 Physical Therapy and Surgery, Western University, St. Joseph’s Health Centre, 268 Grosvenor St, London, Canada



Joint Protection (JP) can be enhanced by incorporating recent evidence and innovations in collaboration with people with hand arthritis to be salient, useful and effectively implemented.


The purpose of this study is to map the current research on JP principles and guide future research on JP programs for the management of hand arthritis.


A search was performed in 4 databases (PubMed, EMBASE, Google SCHOLAR, CINHAL) from January 1990 to February 2017. A Grey literature was also conducted through the Google web search engine. A combination of search terms was used such as hand osteoarthritis, rheumatoid arthritis, joint protection and/or self-management strategies.


Our search found 8,788 citations in which 231 articles were deemed relevant and after duplication 111 articles were retrieved for a full-text review. In total, 40 articles were eligible for data extraction. The majority of the articles were randomized controlled trials (RCTs), systematic reviews and overviews of reviews that investigated joint protection for hand arthritis. Joint protection was tested mostly in rheumatoid arthritis (RA) population and to a lesser extent on hand osteoarthritis and was provided mainly by an occupational therapist.


This review synthesized and critically examined the scope of JP for the management of hand arthritis and found that RCTs, systematic reviews and overviews of reviews constituted two-thirds of the current body of literature. Furthermore, it identified a lack of clarity regarding the specific elements of joint protection programs used in clinical studies.

Keywords: Joint protection, Rheumatoid arthritis, Hand osteoarthritis, Hand arthritis.

Article Information

Identifiers and Pagination:

Year: 2018
Volume: 12
First Page: 500
Last Page: 513
Publisher Id: TOORTHJ-12-500
DOI: 10.2174/1874325001812010500

Article History:

Received Date: 12/8/2018
Revision Received Date: 11/11/2018
Acceptance Date: 19/11/2018
Electronic publication date: 30/11/2018
Collection year: 2018

© 2018 Bobos et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Western’s Bone and Joint Institute, Department of Health and Rehabilitation Sciences, Western University, 1151 Richmond Street, London, Ontario, Canada; Tel: 519 661 2111; E-mail:

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