Exercise Management for People with Hand Osteoarthritis
Overview:
Hand osteoarthritis (OA) is a common painful joint condition and people living with it often have difficulties carrying out daily hand activities (i.e. grasping objects, turning keys, etc). Available research findings suggests that exercises can be used successfully to manage the symptoms of people living with the condition. However, experts disagree on how to use exercises to gain the best possible benefit. Specific details on the type of exercises and how they should be carried out successfully is lacking in the research information available. Research is needed to determine the best possible exercise programme to successfully manage the symptoms of hand OA.
The overall aim of this project is to develop an exercise programme that is practical and useful for people living with hand OA to help ease their painful hands and improve their ability to perform daily activities.
Aims and Objectives:
The specific objectives are to:
- Search the literature to find exercises that people with hand OA can do, how the exercises were developed, how they can be carried out easily and how effective they are.
- Explore the experiences and views of people living with hand OA and health professionals on an existing hand OA exercise programme.
- Explore whether rapid-force exercises of the hand are feasible to do for people with hand pain.
- Develop an exercise programme based on findings from objectives 1, 2 and 3 and test its feasibility in people living with hand OA within the community.
Key Findings:
- An evidence-based hand OA exercise programme, the Rapid-force Hand Osteoarthritis Exercise (Rapid-HOE) programme, was developed following evidence-based exercise development recommendations.
- The Rapid-HOE programme is novel, as it contains rapid-force hand exercises, which is an isotonic dynamic strength training concept known to have benefits in lower limb strength training and people with knee OA.
- This exercise programme had a medium to large effect on hand pain, self-reported function, and physical health status, which established its proof of concept and feasibility in people living with hand OA in the community.
- Although found to be acceptable and practicable, recommendations for its enhancement such as: (i) adaptation to patient specific needs (ii) revision of exercise instructions for better clarity and (iii) the inclusion of exercise videos, should be considered for future use.
- The Rapid-HOE programme is therefore a promising intervention for the management of people living with hand OA and forms preliminary data for a future RCT aimed at establishing its effectiveness.
Outputs:
- Sankah, BEA, Stokes, M and Adams, J. Exercises for hand osteoarthritis: a systematic review of clinical practice guidelines and consensus recommendations. Physical Therapy Reviews 2019 24:3-4, 66-81. doi.org/10.1080/10833196.2019.1649104
- Sankah, B. E. A., Stokes, M., & Adams, J. (2019). Exercise programs for the management of people with hand osteoarthritis: a scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports, 17(4), 461-469. DOI: 10.11124/JBISRIR-2017-003806
- Sankah, BEA, Stokes M, Adams J. Recommendations for Exercises in Hand Osteoarthritis: A Systematic Review Protocol of Clinical Practice Guidelines and Consensus Recommendations. (2018) Physical. Therapy Reviews 23(3): 207-213. Doi: 10.1080/10833196.2018.1482997