Rheumatology International

, Volume 33, Issue 3, pp 725–732 | Cite as

Strengthening exercises to improve hand strength and functionality in rheumatoid arthritis with hand deformities: a randomized, controlled trial

  • Stephanie Robinson Cima
  • Adriana Barone
  • Jaqueline Mello Porto
  • Daniela Cristina Carvalho de Abreu
Original Article


Rheumatoid arthritis (RA) is a systemic inflammatory and chronic disease of joints, which may result in irreversible deformities. To evaluate the effects of an exercise programme aimed at improving the hand strength in individuals with hand deformities resulting from RA and to analyse the impact these exercises have on functionality. Twenty women with RA hand deformities participated in the study. They were randomly divided into two groups as follows: Group 1 (n = 13) had women participating in the exercise programme aimed at improving handgrip (HS) and pinch strengths (PS) as well as the motor coordination of the hand; Group 2 (n = 7) had women with RA who received no treatment for their hands (control). The treatment programme for hands consisted of 20 sessions, twice a week and at-home exercises. Both groups were submitted to Health Assessment Questionnaire (HAQ) and evaluation of HS and PS by means of dynamometry. Re-evaluations were performed after 10 and 20 sessions in Group 1 and after 2 months in Group 2. After 20 sessions of physiotherapy, Group 1 had a significant gain in HS and PS (p < 0.05) in addition to the improvement of functionality as assessed by HAQ (p = 0.016). For Group 2, no difference was found between the variables analysed (p > 0.05). The strengthening exercises for individuals with RA hand deformity are beneficial to improve handgrip and pinch strengths as well as functionality.


Physiotherapy Rheumatoid arthritis Hand exercises Functionality 



Dominant hand

Group 1

Exercised group

Group 2

Control group


Health Assessment Questionnaire


Non-dominant hand


Handgrip strengths


Pinch strengths


Rheumatoid arthritis



The authors would like to thank the support given by the State of São Paulo Foundation for Research–FAPESP. The funding support provided by Research Foundation of São Paulo (FAPESP) allowed the purchase of handgrip dynamometer (JAMAR, model 5030J1). The study sponsors had no involvement in the study. National Counsel of Technological and Scientific Development (CNPq) and Research Foundation of São Paulo (FAPESP).

Conflict of interest



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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Stephanie Robinson Cima
    • 1
  • Adriana Barone
    • 2
  • Jaqueline Mello Porto
    • 1
  • Daniela Cristina Carvalho de Abreu
    • 1
  1. 1.Department of Biomechanics, Medicine and Rehabilitation of Locomotor System, Physiotherapy Course, School of Medicine of Ribeirão Preto FMRP—USPUniversity of São PauloRibeirão PretoBrazil
  2. 2.Centre of Rehabilitation—CERClinical Hospital of Ribeirão Preto—HCRibeirão PretoBrazil

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