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The effectiveness of home hand exercise programmes in rheumatoid arthritis: a systematic review
1Centre for Health Sciences Research, University of Salford, Salford, UK.
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 randomized controlled trials with a 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 led to better short-term outcomes than low-intensity programmes. Such programmes are cost-effective.
Areas Timely For Developing Research:
Further research is required to evaluate methods of helping people with RA maintain long-term home hand exercise.
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