title: Effect of home-based hand exercises in women with hand osteoarthritis: a randomised controlled trial.
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.
  
  
  BACKGROUND
  ISRTCN79019063.
authors.affiliation: Martina Hansens Hospital, Sandvika, Norway.
authors.forename: Toril
authors.initials: T
authors.lastname: Hennig
authors.affiliation: Martina Hansens Hospital, Sandvika, Norway.
authors.forename: Liv
authors.initials: L
authors.lastname: Hæhre
authors.affiliation: Martina Hansens Hospital, Sandvika, Norway.
authors.forename: Vivian Tryving
authors.initials: VT
authors.lastname: Hornburg
authors.affiliation: National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Petter
authors.initials: P
authors.lastname: Mowinckel
authors.affiliation: Martina Hansens Hospital, Sandvika, Norway.
authors.forename: Ellen Sauar
authors.initials: ES
authors.lastname: Norli
authors.affiliation: National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Kjeken
mesh_terms: D000368:Aged; D005081:Exercise Therapy; D005221:Fatigue / Q000517:prevention & control; D005260:Female; D006225:Hand; D018737:Hand Strength; D006801:Humans; D057194:Intention to Treat Analysis; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000534:rehabilitation*; D010146:Pain / Q000517:prevention & control; D016896:Treatment Outcome
keywords: Hand Osteoarthritis; Occupational Therapy; Rehabilitation