Effects of a progressive resistance exercise program in patients with hand osteoarthritis: A randomized, controlled trial with a blinded assessor

Abstract

Objective: To assess the effectiveness of a progressive resistance strength program on pain, function and strength in hand osteoarthritis patients. Design: Randomized controlled trial. Settings: Outpatients, University Hospital. Subjects: Sixty hand osteoarthritis patients were randomly allocated to exercise group ( n = 30) or control group ( n = 30). Intervention: The exercise group performed a progressive resistance strength program for hand muscles over 12 weeks. Both groups had a single education session. Main measures: The primary outcome was pain intensity (numeric pain scale). The secondary outcomes were – AUSCAN Hand Osteoarthritis Index, Cochin Hand Functional Scale for function and grip and pinch strength. A blinded evaluator performed the evaluations at baseline, 6 and 12 weeks. Results: The mean age were 68.9 (8.8) and 64.7 (8.9) for control and exercise groups, respectively. No significant differences between-group was observed for pain after 12 weeks (mean difference between groups was −1.30 (−0.02 to 2.62) for dominant hand and −1.33 (0.01–2.65) for non-dominant hand at T12, with P = 0.085 and 0.295, respectively). Regarding secondary outcomes, statistically significant differences between groups were found in exercise group: AUSCAN index – total score ( P = 0.005), pain ( P = 0.006), function ( P = 0.047), and Cochin scale ( P = 0.042) with the following mean difference between groups: −9.9 (4.07–15.73), −3.26 (1.06–5.46), −5.03 (1.20–8.86), and −6.27 (0.18–12.36), respectively. Conclusion: No difference was observed for pain (numerical pain scale) after the progressive resistance exercise program performed, however in exercise group, an improvement was observed on secondary outcomes such as pain during activities and function for patients with hand osteoarthritis. Level of evidence: 1b