title: Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand osteoarthritis.
abstract: OBJECTIVE
  The aims of this study were to develop recommendations for occupational therapy assessment and design of hand exercise programmes in patients with hand osteoarthritis.
  
  
  METHODS
  An expert group followed a Delphi procedure to reach consensus for up to 10 recommendations for assessment and exercises, respectively. Thereafter, an evidence-based approach was used to identify and appraise research evidence supporting each recommendation, before the recommendations were validated by the expert group.
  
  
  RESULTS
  The process resulted in 10 recommendations for assessment and eight for design of exercise programmes. The literature search revealed that there is a paucity of clinical trials to guide recommendations for hand osteoarthritis, and the evidence for the majority of the recommendations was based on expert opinions. Also, even if a systematic review demonstrates some evidence for the efficacy of strength training exercises in hand OA, the evidence for any specific exercise is limited to expert opinions.
  
  
  CONCLUSIONS
  A first set of recommendations for assessment and exercise in hand osteoarthritis has been developed. For many of the recommendations there is a paucity of research evidence. High-quality studies are therefore needed to establish a high level of evidence concerning functional assessment and the effect of hand exercises in hand osteoarthritis.
authors.affiliation: National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. ingvild.kjeken@diakonsyk.no
authors.forename: Ingvild
authors.initials: I
authors.lastname: Kjeken
mesh_terms: D000328:Adult; D003697:Delphi Technique; D004185:Disability Evaluation; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D005260:Female; D006225:Hand; D018737:Hand Strength; D006801:Humans; D008875:Middle Aged; D009788:Occupational Therapy; D010003:Osteoarthritis / Q000175:diagnosis / Q000534:rehabilitation*; D010146:Pain / Q000534:rehabilitation; D016059:Range of Motion, Articular