Resistance strength training reduces pain, increases function in people with hand OA

Resistance strength training reduces pain and increases function and treatment satisfaction in people with hand osteoarthritis, according to new research findings presented this week at the American College of Rheumatology Annual Meeting in San Francisco.

Osteoarthritis, sometimes called degenerative joint disease, is a slowly progressive disease in which joint cartilage breaks down. Normally, cartilage on the ends of bones allows smooth, pain-free joint movements. In OA, cartilage becomes thin and irregular, resulting in symptoms of joint pain and stiffness. Grinding or cracking sensations may occur. Joints that are under high stress due to repeated activity or weight bearing are most susceptible to OA. The hips, knees, hands and spine are commonly affected. OA becomes more common with aging.

While several studies have shown the effectiveness of exercise therapy on OA of the hips and knees, few studies have looked at the effectiveness of the therapy on hands - most physicians make the recommendation based on their own experiences with patients. To address this, researchers at Universidade Federal de São Paulo in Brazil completed a study to assess the effectiveness of progressive resistance strength training on pain, function and strength in people with hand OA.

"There is a scarce literature regarding strength exercise in hand OA, and there is no consensus about it. So, we decided to do this study to evaluate the effectiveness of progressive strength exercise for these patients," explains lead investigator, Michele Nery PT, MsC; Universidade Federal de São Paulo-Brazil.

The researchers followed 60 participants — who had doctor-diagnosed hand OA for at least one year and who were experiencing pain in the joints of their fingers — for 12 weeks. At the beginning of the study, all participants received instruction on joint protection and energy conservation. Then, the participants were randomly placed into two groups.

The first group followed a progressive resistance exercise program for targeted at the small muscles in the hand and fingers the remainder of the study, and the second group did not.

An evaluator — who was unaware of who was in each group — performed evaluations at the beginning of the study and again at six and 12 weeks. These evaluations utilized a number of tools to measure pain, disability, joint stiffness, and grip and pinch strength. The evaluator noted both groups had very similar results at the beginning of the study with the exception of key pinch strength (using the thumb pad and outside of the index finger) for the non-dominant hand and palmer pinch strength (using the thumb, index and middle fingers) for both hands.

At the end of the study, the evaluator noted that patients in the exercise group show better function, reduced hand pain, and more satisfaction with their treatment when compared to group that did not follow the resistance exercise program.

"This study shows that progressive strength exercise can improve some aspects of hand OA, such as pain and function," explains Nery. "We believe this can be an option for the treatment of hand OA patients, and they should talk to their physicians about it."

Nery's team believes more studies need be done to compare this progressive strength program with another kind of exercise or rehabilitation and suggest those studies follow participants long-term.