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Exercise for Hand Osteoarthritis: A Cochrane Systematic Review
Nina Østerås1,2, Ingvild Kjeken3,4, Geir Smedslund3,4
1From the National Advisory Unit on Rehabilitation in Rheumatology, and the Department of Rheumatology, Diakonhjemmet Hospital; Norwegian Institute of Public Health; University of Oslo, Faculty of Medicine Oslo, Department of Orthopedics, Oslo, Norway. nina.osteras@diakonsyk.no.
The Journal of Rheumatology
|October 17, 2017
Summary
Exercise may offer small to moderate benefits for hand osteoarthritis (OA) pain, function, and stiffness. However, the evidence quality is low, and clinical significance requires further debate.
Area of Science:
- Rheumatology
- Physical Therapy
- Evidence-Based Medicine
Background:
- Hand osteoarthritis (OA) is a prevalent condition causing pain and functional limitations.
- Conservative management strategies, including exercise, are crucial for improving patient outcomes.
Purpose of the Study:
- To systematically review the benefits and harms of therapeutic exercise for individuals with hand OA.
- To compare exercise interventions against placebo or no intervention.
Main Methods:
- A systematic review adhering to Cochrane Collaboration methodology was conducted.
- Searches of six electronic databases were performed up to September 2015.
- Included randomized or controlled clinical trials comparing therapeutic exercise versus no exercise or different exercise programs.
Main Results:
- Low-quality evidence from 5 trials (n=381) suggests exercise may improve hand pain (SMD -0.27), hand function (SMD -0.28), and finger joint stiffness (SMD -0.36) compared to no exercise.
- One study indicated very low-quality evidence for no difference in quality of life.
- Adverse events were infrequent and not severe across three reported studies.
Conclusions:
- Pooled analysis of 5 studies with low risk of bias indicates low-quality evidence for small to moderate benefits of exercise on hand pain, function, and stiffness.
- The clinical importance of the observed effect sizes remains a subject for discussion.