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Effect of home-based hand exercises in women with hand osteoarthritis: a randomised controlled trial
  1. Toril Hennig1,
  2. Liv Hæhre1,
  3. Vivian Tryving Hornburg1,
  4. Petter Mowinckel2,
  5. Ellen Sauar Norli1,
  6. Ingvild Kjeken2
  1. 1Martina Hansens Hospital, Sandvika, Norway
  2. 2National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  1. Correspondence to Ingvild Kjeken, National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vinderen, Oslo NO-0319, Norway; ingvild.kjeken{at}diakonsyk.no

Abstract

Background Hand exercises are recommended for patients with hand osteoarthritis (HOA), though evidence for their effect is conflicting.

Objective To evaluate, in a randomised controlled trial, the effect of HOA information plus home-based hand exercises (exercise group) compared with information only (control group) in women with HOA.

Methods Interventions were delivered by two occupational therapists. Exercise group participants received eight follow-up calls over the 3-month study and recorded adherence, pain after exercises and adverse events in a diary. Primary outcome was activity performance measured after 3 months by the Patient-Specific Functional Scale (PSFS), with a range of 0–10. Secondary outcomes were measurements of hand function, disease activity, symptoms and number of responders to treatment according to the OMERACT-OARSI criteria.

Results Of 80 women randomised (40 : 40) (mean age (SD) 60.8 years (7.0)), follow-up was 89% (n=71). An intention-to-treat analysis was performed. The adjusted mean difference for the exercise versus control group was 1.4 points (95% CI 0.6 to 2.2, effect size 1.0) for the PSFS score. Thirteen patients in the exercise group versus three participants in the control group reached a positive minimal clinical important difference of 2.2 points in the PSFS total score, while none versus two, respectively, had a negative change (p=0.007). For secondary outcomes, significant mean differences were found in grip strength and thumb web space, in fatigue, joint pain and the Functional Index for HOA activity performance scores. Sixteen exercise-group participants fulfilled the OMERACT-OARSI response criteria versus two control-group participants (p<0.001).

Conclusions Hand exercises were well tolerated and significantly improved activity performance, grip strength, pain and fatigue in women with HOA.

Trial registration number ISRTCN79019063.

  • Hand Osteoarthritis
  • Occupational Therapy
  • Rehabilitation

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