Background In a systematic review on the long-term effectiveness of exercise therapy in patients with OA of the knee and/or hip it was suggested that additional booster sessions positively influence the long term effectiveness on pain and limitations in activities (1). The effectiveness of a booster session after non-pharmacological treatment in patients with hand OA utilizing a randomised design has never been investigated.
Objectives To examine the effect of a single booster session on pain and limitations in activities in patients with hand OA on the long term.
Methods Design: randomised controlled trial, nested within cohort study. Included were patients with hand OA according to the clinical ACR classification criteria of whom complaints due to osteoarthritis of hands were the most or second most important problem. All patients received 4 group-based treatment sessions supervised by a specialized nurse and an occupational therapist. Six months after the start of the multidisciplinary treatment program patients were randomly assigned to the experimental (booster-session) or control group (wait and see). Primary outcome measures were the AUSCAN subscale limitations in activities and the OARSI responder criteria one year after the start of multidisciplinary treatment. Secondary outcome measures included measures for self-efficacy, grip strength and joint mobility.
Results 147 patients were included in this studywith a mean (SD) age of 59 (8) years, 84% female. The score on the AUSCAN limitations of activities scale improved from mean (SD) 20.9 (6.2) at baseline to 19.1 (7.7) at one year follow up and from 19.1 (7.2) to 18.0 (8.2) in the experimental and control group, respectively. Between group difference in the AUSCAN limitations in activities subscale at one year follow up was -0.3 (-2.4; 1.7). About one fifth of participants could be classified as a responder (22% versus 23% of participants in the experimental group and the control group, respectively). There were no differences between groups in any of the secondary outcome measures at twelve months follow-up.
Conclusions The long term improvements after a multidisciplinary treatment in hand OA are small. A single booster session after six months has no additional value.
Pisters MF, Veenhof C, van Meeteren NL, Ostelo RW, de Bakker DH, Schellevis FG, Dekker J. Long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review. Arthritis Rheum 2007;57:1245-53
Disclosure of Interest None Declared