Therapeutic Putty-based Hand Strengthening Exercises to Improve Hand Function and Quality of Life in Patients with Chronic Rheumatoid Arthritis

Abstract

Context: Rheumatoid arthritis (RA) primarily affects the hands, leading to disabling joint abnormalities and reduced muscle strength, profoundly impacting hand function and overall quality of life (QOL). Aim: The aim of this study was to find the effect of therapeutic putty-based hand exercises on hand function and QOL in patients with chronic RA. Setting and Design: It was an experimental study conducted at the College of Physiotherapy, Pt. B.D. Sharma, PGIMS, Rohtak. Subjects and Methods: In this study, 206 chronic RA patients were randomly split into two groups. Group A (control) received conventional physiotherapy care including hot fomentation, joint protection advice, active exercises, and splinting. Group B (experimental) engaged in hand strengthening exercises with 85 g of therapeutic putty alongside conventional physiotherapy. Key outcomes assessed grip and key pinch strength, hand function (Short Form of the Score for the Assessment and Quantification of Chronic Rheumatic Affections of the Hands), and QOL (WHO-BREF) at baseline, 4th, 8th, and 12th weeks. Statistical Analysis: Effect of treatment comparison was done with one-way analysis of variance followed by post hoc analysis. Results: The experimental group showed superior outcomes for grip, key strength, and hand function (P = 0.000). Regarding the QOL, improvements were observed in the physical component at the 4th week (P = 0.003) and in both the 8th and 12th weeks (P = 0.000). The psychological, social, and environmental components improved significantly in the 8th and 12th weeks (P < 0.005). Conclusion: A therapeutic putty-based strength training program as an addition to usual care is a worthwhile, low-cost intervention that helps improve function, disability, and QOL.