Group intervention yielded improvements in hand OA measures

A primary care group intervention for patients with osteoarthritis yielded improvements in hand function, activity restrictions and self-reported health, according to findings.

In the prospective cohort study, researchers recruited 49 patients with hand OA treated at a primary care unit in southeast Sweden between 2008 and 2011. Patients took part in an OA group intervention at a primary care facility during a 6-week period. The intervention consisted of education and exercise. The education portion of the program consisted of two group sessions of 1.5 hours each and was based on a previous program used for OA in general and adapted for hand OA. The education portion of the intervention was led by occupational therapists trained in the general program. These sessions were attended by a maximum of 14 participants.

The exercise portion of the program began after the two educational sessions. This program consisted of twice-weekly sessions held during a 6-week period. The sessions each began with a 20-minute paraffin wax bath. The exercise program was intended to increase range of motion, strength and the use of hands in daily activities. A soft ball was utilized to strengthen wrists and hands. A total of 14 different exercises were performed at least five times during the 25-minute sessions. All of the 49 patients engaged in both educational sessions and in all 12 supervised exercise sessions, equaling a total of 15 hours of supervised group intervention per patient.

Researchers found that from baseline to 2 months, there was a significant improvement in grip ability based on the grip ability test. Between 3 months and 12 months, no difference was found in this measure. A significant improvement was seen from baseline to 3 months in range of motion according to signals of functional impairment test. No difference was seen in this measure between 3 months and 12 months.

Grip force measured by JAMAR in the right hand showed a significant improvement from baseline to 3 months, as did grip force in the left hand. Improvements continued in the left hand between 3 months and 12 months, but no such improvements were not evident in the right hand.

A significant decrease in hand pain at rest was seen after 3 months. Between 3 months and 12 months, no difference was seen.

In all activities, activity restrictions stated and rated by the participants in the patient-specific functional scale improved significantly between baseline and 3 months. No difference was seen between 3 months and 12 months.

Significant improvement was seen in activity restrictions according to the Quick DASH from baseline to 3 months. No improvements were observed between 3 months and 1 year.
Significant improvement was also seen in self-rated health measured by EuroQoL VAS between baseline and 3 months and remained consistent until the 12-month follow-up.

“The result shows that a hand OA group intervention including education, paraffin wax bath and exercises appears to be well accepted among participants and a potentially useful group intervention in primary care setting in Sweden,” the researchers wrote “This hand OA group intervention might improve hand function, activity limitation and self-rated health and the effect is sustained up to 1 year.” -by Jennifer Byrne

Disclosures: The researchers report no relevant disclosures.

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Source:

Bjurehed L, et al. Arthritis Care Res. 2017;doi:10.1002/acr.23431.