Exercise for hand osteoarthritis

Abstract

Background-What is hand osteoarthritis and what is exercise? Osteoarthritis (OA) is a disease of the joints that causes joint pain, stiffness and swelling. It may hinder people from doing what they want and need to do. Usually, symptoms come on slowly but get worse over time. OA may occur in any joint but is most commonly seen in the hip, knee and small joints of the hand. No cure for OA is known, but available treatment alternatives may reduce pain and stiffness, increase function and improve self-management of the disease. Exercise is an activity done to improve or maintain your fitness, ability or performance. A period of planned exercise often aims to improve or maintain muscle strength, physical fitness, joint mobility and overall health. Study characteristics This Cochrane review presents what we know about the effect of exercise in people with OA in the joints of the hand. After searching for relevant studies up to September 2015, we included seven studies (534 participants). These studies included more women than men. In six studies, half of the people underwent a hand exercise programme and were compared with those who did not exercise. One study compared two groups of people who underwent two different exercise programmes. Evidence from five studies shows the effect of exercise immediately after the exercise programme, and two studies provided results on medium-and long-term sustainability of exercise. We report below only the results reported immediately after the exercise programme was completed.

The effects of resistance training on muscle strength, joint pain, and hand function in individuals with hand osteoarthritis: a systematic review and meta-analysis

“…Of note, our overall finding concerning grip strength is in contrast to a recent review by Østerås et al [32]. These authors noted that there was a strong trend for an improvement following training.…”

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

“…[H2] Non-pharmacological therapies In a 2017 systemic review, Lue and colleagues 158 provided an update on an earlier review of non-surgical therapies for hand OA Mahendira 2009 and the reader is directed to this manuscript for an appraisal of the quality of some of the studies discussed below. In this section, a summary of the core and adjunctive treatments and surgery are briefly provided.…”

“…Researchers have investigated splints or orthoses for first CMCJ OA 177,178,179,180,181 or IPJ OA 182,173,172,158 as well as pressure gloves for hand arthritis 183 . However, currently, what type of splint is best is unclear and data are inconsistent as to whether splints provide symptom relief in the hand 158 . The use of splints does improve function and pinch strength in patients with first CMCJ OA 172,173 .…”

Recommendations for exercises in hand osteoarthritis: a systematic review protocol of clinical guidelines and consensus recommendations

“…Amongst these, substantial evidence supports the recommendation of exercises [18] , as reported in a high quality systematic review of clinical practice guidelines which concluded that exercise was one of the key recommendations supporting the physical management of OA [24] . Despite the acknowledged benefits of exercise, agreement is lacking on its benefits for people with hand OA [25,28,30] . Whilst some authors have criticised exercise for having minimal or no improvement effect on hand muscle strength and range of motion [29] , others report moderate to high effectiveness in improving pain, daily activity performance and grip strength [16] .…”

“…Whilst some authors have criticised exercise for having minimal or no improvement effect on hand muscle strength and range of motion [29] , others report moderate to high effectiveness in improving pain, daily activity performance and grip strength [16] . In an attempt to address this controversy, a recent Cochrane review, which aimed to evaluate the harms and benefits of exercises in hand OA, concluded that exercises are beneficial for improving hand pain, finger joint stiffness and hand function and cause no adverse effects [30] . The Cochrane review also highlighted the lack of consensus among researchers on the type and the content of exercise interventions most beneficial to this patient population.…”