The effectiveness of home hand exercise programmes in rheumatoid arthritis : a systematic review

Hammond, A; Prior, Y

Abstract

Introduction: Rheumatoid arthritis (RA) commonly reduces hand function. We systematically reviewed trials to investigate effects of home hand exercise programmes on hand symptoms and function in RA.
Sources of Data: We searched: Medline (1946-), AMED, CINAHL, Physiotherapy Evidence Database, OT Seeker, the Cochrane Library, ISI Web of Science from inception to January 2016.
Areas of Agreement: Nineteen trials were evaluated. Only three were randomised controlled trials with low risk of bias (n=665). Significant short-term improvements occurred in hand function, pain and grip strength, with long term improvements in hand and upper limb function and pinch strength.
Areas of controversy: Heterogeneity of outcome measures meant meta-analysis was not possible.
Growing Points: Evaluation of low and moderate risk of bias trials indicated high intensity home hand exercise programmes lead to better short-term outcomes than low intensity programmes. Such programmes are cost-effective.
Areas timely for developing research: Further research is needed to evaluate methods of helping people with RA maintain home hand exercise long-term.

• Journal Article Type: Article
• Acceptance Date: May 3, 2016
• Online Publication Date: Jun 30, 2016
• Publication Date: Sep 9, 2016
• Deposit Date: Jul 26, 2016
• Publicly Available Date: Jun 29, 2017
• Journal: British Medical Bulletin
• Print ISSN: 0007-1420
• Electronic ISSN: 1471-8391
• Publisher: Oxford University Press
• Volume: 119
• Issue: 1
• Pages: 49-62
• DOI: https://doi.org/10.1093/bmb/ldw024
• Publisher URL: https://doi.org/10.1093/bmb/ldw024
• Related Public URLs: http://bmb.oxfordjournals.org/