Development of an evidence-based exercise programme for people with hand osteoarthritis

Kjeken, Ingvild; Grotle, Margreth; Hagen, Kåre Birger; Østerås, Nina

doi:10.3109/11038128.2014.941394

Cited by 19 publications

(19 citation statements)

References 49 publications

(99 reference statements)

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“…The development of the intervention adhered to the framework for the design and evaluation of complex interventions 25 and was based on synthesized evidence from three key sources carrying equal weight: research evidence from a systematic review 7 , clinical expertise and client knowledge 26 . The American College of Sports Medicine's recommendations for developing muscular strength and flexibility in older frail adults 27 were employed for exercise dosage.…”

Section: The Interventionmentioning

confidence: 99%

Limited effects of exercises in people with hand osteoarthritis: results from a randomized controlled trial

Østerås

Hagen

Grotle

et al. 2014

Osteoarthritis and Cartilage

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Section: The Interventionmentioning

confidence: 99%

Limited effects of exercises in people with hand osteoarthritis: results from a randomized controlled trial

Østerås

Hagen

Grotle

et al. 2014

Osteoarthritis and Cartilage

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“…The emphasis on targeting inflammation in hand OA has been further unsettled by the negative results of several randomised controlled studies in hand OA using traditional anti-inflammatory or 'anti-synovial' agents. These findings include a failure to demonstrate a difference between placebo treatment and treatment with hydroxychloroquine 153,154 , anti-TNF agents 155,156 or IL-1 targeting strategies 157 .…”

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confidence: 99%

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

et al. 2018

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Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease.

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“…However, there is a growing body of evidence suggesting that high levels of pain during or immediately after resistance training sessions (up to 6 on a NRS scale) do not negatively affect outcomes, but rather improve overall levels of pain for the duration of the training program in people with hand and knee OA [31, 36, 37]. Such pain intensities have been previously considered acceptable in people with OA, on the condition that pain intensity returns to baseline values within 24 hours of the previous session [31, 38]. …”

Section: Discussionmentioning

confidence: 99%

The effects of resistance training on muscle strength, joint pain, and hand function in individuals with hand osteoarthritis: a systematic review and meta-analysis

2017

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BackgroundHand osteoarthritis is a common condition characterised by joint pain and muscle weakness. These factors are thought to contribute to ongoing disability. Some evidence exists that resistance training decreases pain, improves muscle strength, and enhances function in people with knee and hip osteoarthritis. However, there is currently a lack of consensus regarding its effectiveness in people with hand osteoarthritis. Therefore, the aim of this systematic review and meta-analysis was to establish whether resistance training in people with hand osteoarthritis increases grip strength, decreases joint pain, and improves hand function.MethodsSeven databases were searched from 1975 until July 1, 2016. Randomised controlled trials were included. The Cochrane Risk of Bias Tool was used to assess studies’ methodological quality. The Grade of Recommendations Assessment, Development, and Evaluation system was adopted to rate overall quality of evidence. Suitable studies were pooled using a random-effects meta-analysis.ResultsFive studies were included with a total of 350 participants. The majority of the training programs did not meet recommended intensity, frequency, or progression criteria for muscle strengthening. There was moderate-quality evidence that resistance training does not improve grip strength (mean difference = 1.35; 95% confidence interval (CI) = –0.84, 3.54; I 2 = 50%; p = 0.23 ). Low-quality evidence showed significant improvements in joint pain (standardised mean difference (SMD) = –0.23; 95% CI = –0.42, –0.04; I 2 = 0%; p = 0.02) which were not clinically relevant. Low-quality evidence demonstrated no improvements in hand function following resistance training (SMD = –0.1; 95% CI = –0.33, 0.13; I 2 = 28%; p = 0.39).ConclusionThere is no evidence that resistance training has a significant effect on grip strength or hand function in people with hand osteoarthritis. Low-quality evidence suggests it has a small, clinically unimportant pain-relieving effect. Future studies should investigate resistance training regimes with adequate intensity, frequency, and progressions to achieve gains in muscle strength.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-017-1348-3) contains supplementary material, which is available to authorized users.

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Development of an evidence-based exercise programme for people with hand osteoarthritis

Abstract: An evidence-based exercise programme for people with HOA has been developed. The effect of the programme has recently been evaluated in a randomized controlled trial.

Cited by 19 publications

References 49 publications

Limited effects of exercises in people with hand osteoarthritis: results from a randomized controlled trial

Limited effects of exercises in people with hand osteoarthritis: results from a randomized controlled trial

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

The effects of resistance training on muscle strength, joint pain, and hand function in individuals with hand osteoarthritis: a systematic review and meta-analysis

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