The controversy over the relative value of heat and cold applications for rheumatoid arthritis (RA) has been going on for a long time. Clinicians often allow patients to choose which thermal agent they prefer. The purpose of this study was to help clinicians select the correct thermal agent as part of the overall treatment of patients with RA by determining if there was a significant difference between heat and cold application on the hand function of persons with RA. Fourteen subjects were randomly assigned to receive either heat or cold treatment and to administer that particular modality to either the right or left hand. The opposite hand served as a control and therefore was measured but not treated. Subjects were instructed to treat the proper hand once a day, five times in the next week. Measurements of the subjects' grip strength, timing of coin count and pegboard functional tests, and ratings of pain and joint stiffness were measured before and after the treatment period. There was a significant difference (p < 0.05) between the pre and posttest joint stiffness scores indicating that subjects perceived a decrease in joint stiffness when using heat and an increase in joint stiffness when using cold. however, there was not a significant difference (p < 0.05) between the pre and posttest scores on grip strength, coin count, pegboard, and joint pain for the heat and cold groups. These findings suggest that both heat and cold applications are effective treatments for hands of patients with RA.
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