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

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Abstract

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.

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Notes

  1. B&L Engineering; 1901 Carnegie Ave., Suite Q. Santa Ana, CA, USA. 92705.

  2. Sammons Preston Rolyan; 452 N. Sangamon. Chicago, IL, USA. 60622.

Abbreviations

DH:

Dominant hand

Group 1:

Exercised group

Group 2:

Control group

HAQ:

Health Assessment Questionnaire

NDH:

Non-dominant hand

HS:

Handgrip strengths

PS:

Pinch strengths

RA:

Rheumatoid arthritis

References

  1. ACR Clinical Guidelins (1996) Committee guidelines for the management of rheumatoid arthritis. Arthritis Rheum 39(5):713–722

    Article  Google Scholar 

  2. Noordhoek J, Loschiavo FQ (2007) Custom-designed hand orthosis in acute rheumatoid arthritis. Revista Brasileira de Reumatologia 47(2):121–122

    Article  Google Scholar 

  3. O’Brien AV, Jones P, Mullis R, Mulherin D, Dziedzic K (2006) Conservative hand therapy treatments in rheumatoid arthritis–a randomized controlled trial. Rheumatology (Oxford) 45(5):577–583. doi:10.1093/rheumatology/kei215

    Article  Google Scholar 

  4. Brorsson S, Hilliges M, Sollerman C, Nilsdotter A (2009) A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis. J Rehabil Med 41(5):338–342. doi:10.2340/16501977-0334

    Article  PubMed  Google Scholar 

  5. Jones E, Hanly JG, Mooney R, Rand LL, Spurway PM, Eastwood BJ, Jones JV (1991) Strength and function in the normal and rheumatoid hand. J Rheumatol 18(9):1313–1318

    PubMed  CAS  Google Scholar 

  6. Ferraz MB, Oliveira LM, Araujo PM, Atra E, Tugwell P (1990) Crosscultural reliability of the physical ability dimension of the health assessment questionnaire. J Rheumatol 17(6):813–817

    PubMed  CAS  Google Scholar 

  7. Schall R (1991) Estimation in generalized linear models with random effects. Biometrika 78(4):719

    Article  Google Scholar 

  8. Agresti A (2002) Categorical data analysis, 2a edn. Wiley, New york

    Book  Google Scholar 

  9. Pagano M, Gauvreau K (2004) Princípios de bioestatística, 2ª edn.

  10. Institute SAS, Inc SS (2003) User’s guide, Version 9. SAS Institute Inc, Cary

    Google Scholar 

  11. Akhavani MA, Paleolog EM, Kang N (2011) Muscle hypoxia in rheumatoid hands: does it play a role in ulnar drift? J Hand Surg Am 36(4):677–685. doi:10.1016/j.jhsa.2011.01.035

    Article  PubMed  Google Scholar 

  12. Louzada-Junior P, Souza BDB, Toledo RA, Ciconelli RM (2007) Análise descritiva das características demográficas e clínicas de pacientes com artrite reumatoide no estado de São Paulo. Brasil. rev bras reumatol 47(2):84–90

    Article  Google Scholar 

  13. Hammond A (2004) Rehabilitation in rheumatoid arthritis: a critical review. Musculoskeletal Care 2(3):135–151. doi:10.1002/msc.66

    Article  PubMed  Google Scholar 

  14. Flint-Wagner HG, Lisse J, Lohman TG, Going SB, Guido T, Cussler E, Gates D, Yocum DE (2009) Assessment of a sixteen-week training program on strength, pain, and function in rheumatoid arthritis patients. J Clin Rheumatol 15(4):165–171. doi:10.1097/RHU.0b013e318190f95f

    Article  PubMed  Google Scholar 

  15. de Jong Z, Munneke M, Zwinderman AH, Kroon HM, Ronday KH, Lems WF, Dijkmans BA, Breedveld FC, Vliet Vlieland TP, Hazes JM, Huizinga TW (2004) Long term high intensity exercise and damage of small joints in rheumatoid arthritis. Ann Rheum Dis 63(11):1399–1405. doi:10.1136/ard.2003.015826

    Article  PubMed  Google Scholar 

  16. Hoenig H, Groff G, Pratt K, Goldberg E, Franck W (1993) A randomized controlled trial of home exercise on the rheumatoid hand. J Rheumatol 20(5):785–789

    PubMed  CAS  Google Scholar 

  17. Ronningen A, Kjeken I (2008) Effect of an intensive hand exercise programme in patients with rheumatoid arthritis. Scand J Occup Ther 15(3):173–183. doi:10.1080/11038120802031129

    Article  PubMed  Google Scholar 

  18. Buljina AI, Taljanovic MS, Avdic DM, Hunter TB (2001) Physical and exercise therapy for treatment of the rheumatoid hand. Arthritis Rheum 45(4):392–397. doi:10.1002/1529-0131(200108)45:4<392:AID-ART353>3.0.CO;2-2

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

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).

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Authors and Affiliations

  1. Department of Biomechanics, Medicine and Rehabilitation of Locomotor System, Physiotherapy Course, School of Medicine of Ribeirão Preto FMRP—USP, University of São Paulo, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, CEP: 14049-900, Brazil

    Stephanie Robinson Cima, Jaqueline Mello Porto & Daniela Cristina Carvalho de Abreu

  2. Centre of Rehabilitation—CER, Clinical Hospital of Ribeirão Preto—HC, Ribeirão Preto, Brazil

    Adriana Barone

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  1. Stephanie Robinson Cima
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  2. Adriana Barone
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  3. Jaqueline Mello Porto
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  4. Daniela Cristina Carvalho de Abreu
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Correspondence to Daniela Cristina Carvalho de Abreu.

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Cima, S.R., Barone, A., Porto, J.M. et al. Strengthening exercises to improve hand strength and functionality in rheumatoid arthritis with hand deformities: a randomized, controlled trial. Rheumatol Int 33, 725–732 (2013). https://doi.org/10.1007/s00296-012-2447-8

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  • DOI: https://doi.org/10.1007/s00296-012-2447-8

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