Progressive Strength in Hand Osteoarthritis

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

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.

Study Overview

• Status: Completed
• Conditions: Hand Osteoarthritis
• Intervention / Treatment: Other: Progressive resistance strength training program; Other: Joint protection and energy conservation advice

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Phase 4

Contacts and Locations

Study Locations

• Brazil
  • SP
    • Sao Paulo, SP, Brazil, 04023900
      • Universidade Federal de Sao Paulo

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

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

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Federal University of São Paulo

Study record dates

Study Major Dates

• Study Start: October 1, 2013
• Primary Completion (Actual): January 1, 2015
• Study Completion (Actual): October 1, 2015

Study Registration Dates

• First Submitted: August 17, 2015
• First Submitted That Met QC Criteria: August 18, 2015
• First Posted (Estimate): August 19, 2015

Study Record Updates

• Last Update Posted (Actual): February 23, 2017
• Last Update Submitted That Met QC Criteria: February 19, 2017
• Last Verified: February 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Arthritis; Osteoarthritis
• Other Study ID Numbers: CEP UNIFESP