Session Information
Date: Sunday, November 8, 2015
Title: Osteoarthritis - Clinical Aspects: Treatments and Epidemiology
Session Type: ACR Concurrent Abstract Session
Session Time: 2:30PM-4:00PM
Background/Purpose: Hand osteoarthritis (OA) is highly prevalent, affecting 55-70% of the population over 55 years with an age-related progressive increase. The OA of interphalangeal (IF) and carpometacarpaljoints may have varying degrees of deformity associated with pain, decreased of grip and pinch strength, decreased range of motion and functional impairment. Systematic reviews and meta-analyzes have shown the beneficial effect of exercise for lower limb OA, however for hand OA exercise is still used based on recommendations based on clinical experience and low quality studies, not allowing a conclusion about the effects of exercise in pain, function and strength in hand OA patients. The purpose of this study was to assess the effectiveness of progressive resistance strength training program on pain, function and strength in hand OA patients.
Methods: diagnostic of hand OA according to ACR of at least 1year, age over 55 years, both genders, pain in IF joints between 3-8 cm on a 10-cm numerical pain scale (NPS). Sixty patients who meet the eligibility criteria were randomized into exercise group (EG) and control group (CG). Both groups performed a session regarding joint protection and energy conservation before randomization. The EG performed a progressive resistance strength training program for intrinsic muscles of the hand for 12 weeks. The outcome measures were NPS; Australian/Canadian (AUSCAN) Hand Osteoarthritis Index and Cochin Hand Functional Scalefor hand function; grip and pinch strengthening using the JamarHydraulic HandDynamometer and a pinch gauge dynamometer and satisfaction with the treatment using a Likert scale. A blinded evaluator performed the evaluations at baseline, 6 and 12 weeks after treatment baseline.
Results: The groups were homogeneous at baseline except for the key pinch strength for non-dominant hand and palmar pinch strength for both hands. The comparison between groups using repeated measures ANOVA shows an statistically difference between groups in AUSCAN (total score, p = 0.005; pain, p = 0.006 and function, p = 0.047), COCHIN (p = 0.042) and Likert scale (p = 0.001) with better results for the EG.
Conclusion: This progressive resistance strength training program was effective for pain, function, and treatment satisfaction for patients with hand OA.
Table 1 – Between-groups comparison for pain, function and strength
|
|
T0 |
T6 |
T12 |
|
|||
|
|
CG |
EG |
CG |
EG |
CG |
EG |
p |
|
NPS |
|
|
|
|
|
|
|
|
Dominant hand |
6.13 ± 1.63 |
6.33 ± 1.67 |
4.63 ± 2.71 |
4.40 ± 2.49 |
5.10 ± 2.68 |
3.80 ± 2.43 |
0.085 |
|
Non-dominant hand |
5.93 ± 1.70 |
5.67 ± 1.69 |
4.73 ± 2.63 |
4.20 ± 2.47 |
5.10 ± 2.58 |
3.77 ± 2.53 |
0.295 |
|
AUSCAN |
|
||||||
|
Pain |
8.47 ± 3.01 |
7.90 ± 4.49 |
8.93 ± 3.56 |
5.73 ± 4.24 |
8.23 ± 4.42 |
4.97 ± 4.07 |
0.006* |
|
Stiffness |
2.20 ± 2.16 |
1.97 ± 1.00 |
2.33 ± 1.73 |
1.73 ± 1.51 |
2.13 ± 1.28 |
1.17 ± 1.15 |
0.386 |
|
Function |
14.0 ± 7.05 |
12.67 ± 7.99 |
15.00 ± 7.08 |
11.77 ± 7.60 |
13.80 ± 7.42 |
8.77 ± 7.40 |
0.047* |
|
Total score |
24.70 ± 9.66 |
22.50 ± 12.10 |
26.30 ± 10.02 |
19.10 ± 10.47 |
24.13 ± 12.02 |
14.23 ± 10.47 |
0.005* |
|
COCHIN |
15.73 ± 10.37 |
14.53 ± 13.83 |
18.00 ± 12.26 |
12.30 ± 12.10 |
15.17 ± 11.71 |
8.90 ± 12.09 |
0.042* |
|
GRIP STRENGTH |
|
||||||
|
Dominant hand |
15.18 ± 4.20 |
17.70 ± 5.2 |
14.90 ± 4.10 |
18.70 ± 5.10 |
15.60 ± 5.10 |
19.10 ± 4.70 |
0.052 |
|
Non-dominant t hand |
14.70 ± 4.20 |
16.50 ± 5.10 |
14.10 ± 3.80 |
16.90 ± 5.20 |
14.90 ± 4.50 |
17.80 ± 5.00 |
0.307 |
|
PINCH STRENGTH |
|
|
|
|
|
|
|
|
Tip |
|
||||||
|
Dominant hand |
4.11 ± 1.28 |
4.51 ± 1.20 |
4.21 ± 0.95 |
4.44 ± 1.29 |
4.10 ± 1.16 |
4.54 ± 1.21 |
0.586 |
|
Non-dominant t hand |
3.87 ± 1.10 |
5.39 ± 5.71 |
3.91 ± 1.12 |
4.48 ± 1.21 |
3.76 ± 1.00 |
4.31 ± 1.15 |
0.372 |
|
Key |
|
||||||
|
Dominant hand |
5.78 ± 1.27 |
6.36 ± 1.12 |
5.69 ± 1.32 |
6.30 ± 1.14 |
5.95 ± 1.52 |
6.54 ± 1.06 |
0.984 |
|
Non-dominant hand |
5.18 ± 1.07 |
5.88 ± 1.00 |
5.26 ± 1.05 |
6.00 ± 0.98 |
5.33 ± 1.12 |
7.76 ± 8.98 |
0.308 |
|
Palmar |
|
||||||
|
Dominant hand |
4.53 ± 1.24 |
5.18 ± 1.18 |
4.79 ± 1.18 |
5.18 ± 1.17 |
4.71 ± 1.18 |
5.12 ± 1.05 |
0.387 |
|
Non-dominant hand |
4.16 ± 1.25 |
4.89 ± 1.12 |
4.42 ± 1.38 |
4.92 ± 0.97 |
4.40 ± 1.10 |
4.99 ± 1.01 |
0.502 |
T0= baseline; T6= evaluation after 6 weeks; T12= evaluation after 12 weeks; CG= control group; EG= exercise group;
ANOVA= analysis of variance for repeated measures; NPS= numerical pain scale; AUSCAN= Australian and Canadian Hand
Osteoarthritis Index; pinch and grip strength (Kg/f); *Statistically significant p value (<0,05).
To cite this abstract in AMA style:
Nery MV, Martinez A, Jennings F, Souza M, Natour J. Effectiveness of a Progressive Resistence Strength Programme on Hand Osteoarthritis: A Randomized Crontrolled Trial [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/effectiveness-of-a-progressive-resistence-strength-programme-on-hand-osteoarthritis-a-randomized-crontrolled-trial/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/effectiveness-of-a-progressive-resistence-strength-programme-on-hand-osteoarthritis-a-randomized-crontrolled-trial/