Martina Hansens Hospital, Sandvika, Norway.
National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Ann Rheum Dis. 2015 Aug;74(8):1501-8. doi: 10.1136/annrheumdis-2013-204808. Epub 2014 Mar 25.
Hand exercises are recommended for patients with hand osteoarthritis (HOA), though evidence for their effect is conflicting.
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.
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.
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).
Hand exercises were well tolerated and significantly improved activity performance, grip strength, pain and fatigue in women with HOA.
ISRTCN79019063.
手部运动被推荐用于手部骨关节炎（HOA）患者，但关于其疗效的证据存在争议。
在一项随机对照试验中，评估 HOA 信息加家庭手部运动（运动组）与仅提供信息（对照组）对 HOA 女性的影响。
干预措施由两名职业治疗师提供。运动组参与者在 3 个月的研究期间接受了 8 次随访电话，并在日记中记录了依从性、运动后疼痛和不良事件。主要结局是在 3 个月后通过患者特异性功能量表（PSFS）测量的活动表现，范围为 0-10。次要结局是根据 OMERACT-OARSI 标准测量手部功能、疾病活动、症状和对治疗有反应的人数。
80 名女性随机分组（40:40）（平均年龄（SD）60.8 岁（7.0）），随访率为 89%（n=71）。进行了意向治疗分析。运动组与对照组相比，PSFS 评分的调整平均差异为 1.4 分（95%CI 0.6 至 2.2，效应大小 1.0）。运动组中有 13 名患者和对照组中有 3 名患者在 PSFS 总分中达到了 2.2 分的最小临床重要差异，而运动组中没有患者和对照组中各有 2 名患者的 PSFS 总分出现负向变化（p=0.007）。对于次要结局，在握力和拇指掌指关节间隙、疲劳、关节疼痛和 HOA 活动表现功能指数评分方面，均发现了显著的平均差异。16 名运动组参与者符合 OMERACT-OARSI 反应标准，而对照组只有 2 名参与者符合（p<0.001）。
手部运动耐受性良好，显著改善了 HOA 女性的活动表现、握力、疼痛和疲劳。
ISRTCN79019063。
