Background/Purpose:

Even if hand exercises is regarded as a core treatment for individuals with hand osteoarthritis (HOA), the evidence for the effect is limited. The main aim of this study, therefore, was to evaluate the effect of a hand exercise program in women with HOA. 

Methods:

In this observer blinded, randomised controlled trial ((ISRTCN79019063), 40 women with HOA received information and instruction in hand exercises (E-group), and 40 women received information only (control (C)-group). The exercise program followed the American College of Sports Medicine recommendations for developing muscular strength and flexibility in older frail adults, and included a warm-up period, two exercises to maintain/increase flexibility of the MCP, PIP and DIP joints, one exercise to strengthen the thumb extensors and abductors to maintain thumb web space and increase thumb stability, one exercise to increase grip strength, and a stretching exercise to prevent thumb adduction deformities. E-group participants recorded date, duration of the exercise session and pain following exercising in a diary, and received eight follow-up telephone calls during the three month study period.
Primary outcome was activity performance measured by the Patient Specific Functional Scale (PSFS) on a 0-10 scale (10=good performance). Secondary outcomes included measures of grip strength, joint mobility, thumb web space, pain, disease activity, stiffness and fatigue. Analysis of covariance was used to estimate between group differences at three months follow-up, with scores at three months as dependent variable, taking baseline values as covariates.

Results:

Seventyone participants (mean age 60.8, SD 7.0) completed all assessments. Median number (min, max) of exercise sessions in the E-group in the study period was 37 (26, 43), and median time used pr session was 23.6 minutes (10.4, 42.0).Hand exercises was associated with significant improvement in the PSFS score (adjusted mean difference in change between groups 1.4, p<0.001).Concerning secondary outcomes, hand exercises significantly predicted improvement in fatigue, (mean adjusted differences in change between groups -1.1, p=0.05), in joint pain (-1.1, p=0.02), in grip strength in right (53.5 N, p<0.001) and left (44.6 N, p<0.001) hand, in thumb web space of the right (0.6, p=0.018) and left (0.7, p=0.007) hand, and in the FIHOA activity performance score (-3.2, p<0.001).
While measures of joint mobility in general were stable in the E-group, there was a trend towards deterioration in the C-group, with a significant increase in flexion deficit of 5.4 mm in the right hand (p=0.009).

Conclusion: Hand exercises is well tolerated and significantly improves activity performance, grip strength and pain in women with HOA.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/hand-exercises-significantly-improved-activity-performance-grip-strength-and-pain-in-women-with-hand-osteoarthritis-results-from-a-randomised-controlled-trial/