Summary Part I of this study explores how grip strength and total finger flexion of the hand in patients with rheumatic disease influence the abilities to perform daily activities. The second part of the study examines what kind of hand exercises which give the best results. Part III shows to what extent an improvement of grip strength may improve the performance of daily tasks.

Methods In Part I, the grip strength are tested with a Martin Vigorimeter. The measurement of the total finger flexion is done with a ruler. The level of ability in performing daily activities is measured according to the definitions of “The Assessment of Motor and Process Skills” (AMPS) in 229 in – patients with rheumatic disease. In Part II, 194 patients have carried out a four weeks program of balanced, resistive exercises for the hand with therapeutic putty and was tested for grip strength. 153 patients out of these was tested for total finger flexion. A group of 5 patients have carried out a four weeks program for the hands, of Range of Motion (ROM) – exercises, without any resistance added. In Part III, 13 patients are tested with the Grip Ability Test (The GAT – Test) to see if they have accomplished increased abilities in performing daily activities after four weeks of resistive hand exercises.

Controls 5 in-patients at the same centre, did not attend to the hand exercise groups, but participated in the other exercise programme for all the in-patients (Pool exercises and physical therapy).

Results for Part I The analysis shows significant results both on the connexion between the grip strength and the total finger flexion and the ability to perform daily activities. Grip strength was proved to be a more important factor for performing the tasks of daily living than total finger flexion.

Results Part II Those who carried out hand exercises with therapeutic putty (n = 194), accomplished an increase of 27% in grip strength. Those who also were tested for total finger flexion (n = 153), had increased the ROM of the total finger flexion with an average of 14%. Those who only carried out ROM exercises, increased 1% of grip strength and 11% in range of motion. The control group, which did not participate in any kind of hand exercise, had increased the grip strength with 1,5%, but had no change in ROM of the hand.

Results Part III The GAT-test (the Grip Ability Test) showed a significant improvement of the level of ability to perform daily activities for those who had increased their grip strength.