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Exercises for hand osteoarthritis: A systematic review of clinical practice guidelines and consensus recommendations

Exercises for hand osteoarthritis: A systematic review of clinical practice guidelines and consensus recommendations
Exercises for hand osteoarthritis: A systematic review of clinical practice guidelines and consensus recommendations
Background: Individuals with hand osteoarthritis (OA) often experience hand pain, joint stiffness and reduced grip strength, which affect performance of everyday functional tasks. There is a need to evaluate evidence-based rehabilitation strategies that aim to lessen the burden and improve the quality of life of people living with hand OA.

Objectives: Our objectives were to (1) identify guidelines and consensus recommendations on hand OA management to ascertain whether hand exercises are recommended as part of best practice; (2) identify the type and dosage of exercises recommended regarding frequency, intensity and duration and (3) provide a summary of exercise recommendations for the management of hand OA.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and was registered on Prospero (CRD42018086440). Seven published databases and 20 grey literature sources were searched (January 1997–January2019). Quality assessment was conducted with the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument and, using a narrative approach, evidence was synthesized based on the levels of evidence and strength of recommendations.

Results: Eight guidelines and consensus recommendations were identified and included. Evidence from seven guidelines was rated between fair to high quality. Five out of seven guidelines recommended exercises for the management of hand OA. Limited information on exercise dosage (frequency, intensity and duration) was reported. Three strong and two weak recommendations for using different hand exercises were proposed in this systematic review.

Conclusion: Available guidelines and consensus recommendations on hand OA recommend exercises as part of current best practice for hand OA management. There is strong evidence to support the recommendation of strengthening, stretching and joint mobility exercises for the management of the hand OA. These recommended exercises, however, lacked specific details regarding the type and dosage (frequency, intensity and time) for optimal uptake, which therefore need to be established through research.
1083-3196
Sankah, Beatrice E.A.
0c1c60a8-f327-4381-b84e-8469fa82943c
Stokes, Maria
71730503-70ce-4e67-b7ea-a3e54579717f
Adams, Jo
6e38b8bb-9467-4585-86e4-14062b02bcba
Sankah, Beatrice E.A.
0c1c60a8-f327-4381-b84e-8469fa82943c
Stokes, Maria
71730503-70ce-4e67-b7ea-a3e54579717f
Adams, Jo
6e38b8bb-9467-4585-86e4-14062b02bcba

Sankah, Beatrice E.A., Stokes, Maria and Adams, Jo (2019) Exercises for hand osteoarthritis: A systematic review of clinical practice guidelines and consensus recommendations. Physical Therapy Reviews. (doi:10.1080/10833196.2019.1649104).

Record type: Article

Abstract

Background: Individuals with hand osteoarthritis (OA) often experience hand pain, joint stiffness and reduced grip strength, which affect performance of everyday functional tasks. There is a need to evaluate evidence-based rehabilitation strategies that aim to lessen the burden and improve the quality of life of people living with hand OA.

Objectives: Our objectives were to (1) identify guidelines and consensus recommendations on hand OA management to ascertain whether hand exercises are recommended as part of best practice; (2) identify the type and dosage of exercises recommended regarding frequency, intensity and duration and (3) provide a summary of exercise recommendations for the management of hand OA.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and was registered on Prospero (CRD42018086440). Seven published databases and 20 grey literature sources were searched (January 1997–January2019). Quality assessment was conducted with the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument and, using a narrative approach, evidence was synthesized based on the levels of evidence and strength of recommendations.

Results: Eight guidelines and consensus recommendations were identified and included. Evidence from seven guidelines was rated between fair to high quality. Five out of seven guidelines recommended exercises for the management of hand OA. Limited information on exercise dosage (frequency, intensity and duration) was reported. Three strong and two weak recommendations for using different hand exercises were proposed in this systematic review.

Conclusion: Available guidelines and consensus recommendations on hand OA recommend exercises as part of current best practice for hand OA management. There is strong evidence to support the recommendation of strengthening, stretching and joint mobility exercises for the management of the hand OA. These recommended exercises, however, lacked specific details regarding the type and dosage (frequency, intensity and time) for optimal uptake, which therefore need to be established through research.

Text
Exercises for Hand Osteoarthritis A Systematic Review of Clinical Practice Guidelines and Consensus Recommendations - Accepted Manuscript
Restricted to Repository staff only until 16 July 2020.
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More information

Accepted/In Press date: 16 July 2019
e-pub ahead of print date: 18 August 2019

Identifiers

Local EPrints ID: 433165
URI: https://eprints.soton.ac.uk/id/eprint/433165
ISSN: 1083-3196
PURE UUID: f1e8c218-d5d1-439e-8008-20d09ee987a2
ORCID for Maria Stokes: ORCID iD orcid.org/0000-0002-4204-0890
ORCID for Jo Adams: ORCID iD orcid.org/0000-0003-1765-7060

Catalogue record

Date deposited: 09 Aug 2019 16:30
Last modified: 03 Sep 2019 00:39

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