Progressive Strength in Hand Osteoarthritis

Study Overview
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Brief Summary
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Background: Hand osteoarthritis (OA) is highly prevalent, affecting 55-70% of the population over 55 years with an age-related progressive increase. The OA of interphalangeal (IF) and carpometacarpal joints may have varying degrees of deformity associated with pain, decreased of grip and pinch strength, decreased range of motion and functional impairment. Systematic reviews and meta-analyzes have shown the beneficial effect of exercise for lower limb OA, however for hand OA exercise is still used based on recommendations based on clinical experience and low quality studies, not allowing a conclusion about the effects of exercise in pain, function and strength in hand OA patients. Objective: assess the effectiveness of progressive resistance strength training program on pain, function and strength in hand OA patients. Methods: diagnostic of hand OA according to American College of Rheumatology of at least 1year, age over 50 years, both genders, pain in IF joints between 3-8 cm on a 10-cm numerical pain scale (NPS). Sixty patients who meet the eligibility criteria were randomized into exercise group (EG) and control group (CG). Both groups performed a session regarding joint protection and energy conservation before randomization. The EG performed a progressive resistance strength training program for intrinsic muscles of the hand for 12 weeks. The outcome measures were NPS; Australian/Canadian (AUSCAN) Hand Osteoarthritis Index and Cochin Hand Functional Scale for hand function; grip and pinch strengthening using the Hydraulic Hand Dynamometer and a pinch gauge dynamometer and satisfaction with the treatment using a Likert scale. A blinded evaluator performed the evaluations at baseline, 6 and 12 weeks after treatment baseline.

Official Title
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Effectiveness of a Progressive Resistance Strength Program on Hand Osteoarthritis: a Randomized Controlled Trial

Conditions
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Hand Osteoarthritis

Intervention / Treatment
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* Other: Progressive resistance strength training program
* Other: Joint protection and energy conservation advice


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnostic of hand OA according to american college of rheumatology of at least 1year; age over 50 years; both genders; pain in interphalangeal joints between 3-8 cm on a 10-cm numerical pain scale Exclusion Criteria: other joint disease in hands; other rheumatic systemic disease; surgery in hands or writs; exercise or joint injection in hands in the previous 3 months; disability to perform the exercises.

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exercise group<br>Performed a session regarding joint protection and energy conservation and a progressive resistance strength training program for intrinsic muscles of the hand for 12 weeks. | Other: Progressive resistance strength training program<br>* Patients undergo to strength training for intrinsic muscles of the hand twice a week, during 12 weeks.<br>Other: Joint protection and energy conservation advice<br>* A session regarding joint protection and energy conservation for hands was done before randomization.<br>|
| Active Comparator: Control group<br>Performed a session regarding joint protection and energy conservation | Other: Joint protection and energy conservation advice<br>* A session regarding joint protection and energy conservation for hands was done before randomization.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Pain | Measured by a numerical pain scale | Baseline, after 6 and 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in hand function | measured by AUSCAN | Baseline, after 6 and 12 weeks | 
| Change in Patient satisfaction with treatment | Measured by a Likert scale | 6 and 12 weeks | 
| Change in grip strength | Measured by a Grip Hydraulic Hand Dynamometer | Baseline, after 6 and 12 weeks | 
| Change in hand function | Measured by COCHIN questionnaires | Baseline, after 6 and 12 weeks | 
| Change in pinch stength | Measured by pinch gauge dynamometer | Baseline, after 6 and 12 weeks |