title: The effectiveness of home hand exercise programmes in rheumatoid arthritis: a systematic review.
abstract: Rheumatoid arthritis (RA) commonly reduces hand function. We systematically reviewed trials to investigate effects of home hand exercise programmes on hand symptoms and function in RA.
  
  
  
  We searched: Medline (1946-), AMED, CINAHL, Physiotherapy Evidence Database, OT Seeker, the Cochrane Library, ISI Web of Science from inception to January 2016.
  
  
  
  Nineteen trials were evaluated. Only three were randomized controlled trials with a low risk of bias (n = 665). Significant short-term improvements occurred in hand function, pain and grip strength, with long-term improvements in hand and upper limb function and pinch strength.
  
  
  
  Heterogeneity of outcome measures meant meta-analysis was not possible.
  
  
  
  Evaluation of low and moderate risk of bias trials indicated high-intensity home hand exercise programmes led to better short-term outcomes than low-intensity programmes. Such programmes are cost-effective.
  
  
  
  Further research is required to evaluate methods of helping people with RA maintain long-term home hand exercise.
authors.affiliation: Centre for Health Sciences Research, University of Salford, Salford, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Hammond
authors.affiliation: Centre for Health Sciences Research, University of Salford, Salford, UK.
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Prior
mesh_terms: D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000628:therapy*; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy / Q000379:methods*; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D010349:Patient Compliance; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: exercise; hand; rehabilitation; rheumatoid arthritis; upper limb