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A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis
Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS).
Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS).
Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg.
R & D Center, Spenshults Hospital of Rheumatic Diseases .
2009 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 5, p. 338-342Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

To evaluate the effects of hand exercise in patients with rheumatoid arthritis, and to compare the results with healthy controls.

METHODS:

Forty women (20 patients with rheumatoid arthritis and 20 healthy controls) performed a hand exercise programme. The results were evaluated after 6 and 12 weeks with hand force measurements (with a finger extension force measurement device (EX-it) and finger flexion force measurement with Grippit). Hand function was evaluated with the Grip Ability Test (GAT) and with patient relevant questionnaires (Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-36). Ultrasound measurements were performed on m. extensor digitorum communis for analysis of the muscle response to the exercise programme.

RESULTS:

The extension and flexion force improved in both groups after 6 weeks (p < 0.01). Hand function (GAT) also improved in both groups (p < 0.01). The rheumatoid arthritis group showed improvement in the results of the DASH questionnaire (p < 0.05). The cross-sectional area of the extensor digitorum communis increased significantly in both groups measured with ultrasound.

CONCLUSION:

A significant improvement in hand force and hand function in patients with rheumatoid arthritis was seen after 6 weeks of hand training; the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for rheumatoid arthritis patients, leading to better strength and function.

Place, publisher, year, edition, pages
Basingstoke: Taylor & Francis, 2009. Vol. 41, no 5, p. 338-342
Keywords [en]
Hand exercise therapy, Rheumatoid arthritis, Extension force, Muscle architecture, Ultrasound, Hand strength, DASH, SF-36
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hh:diva-2626DOI: 10.2340/16501977-0334ISI: 000266097400007PubMedID: 19363566Scopus ID: 2-s2.0-64349122505Local ID: 2082/3028OAI: oai:DiVA.org:hh-2626DiVA, id: diva2:239844
Available from: 2009-06-24 Created: 2009-06-24 Last updated: 2018-03-23Bibliographically approved
In thesis
1. Biomechanical studies of finger extension function. Analysis with a new force measuring device and ultrasound examination in rheumatoid arthritis and healthy muscles
Open this publication in new window or tab >>Biomechanical studies of finger extension function. Analysis with a new force measuring device and ultrasound examination in rheumatoid arthritis and healthy muscles
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims:

The overall aim of this thesis was to further our understanding of extensor muscles and their role for hand function.

The aims of the studies were:

To develop and evaluate a new device for finger extensor force measurements. To evaluate ultrasound as a tool for assessment of muscle architecture. To determine the correlation between extensor muscle force and hand function. To evaluate the degree of impaired finger extensor force in rheumatoid arthritis (RA) and the correlation to impaired... mer hand function. To analyse the effect of hand exercise in RA patients and healthy subjects with ultrasound and finger extension force measurements.

Method:

A new finger extension force measuring device was developed and an ultrasound based method was used to be able to objectively measure the finger extension force and analyze the static and dynamic extensor muscle architectures. Measurements were made of healthy volunteers (n=127) and RA patients (n=77) during uninfluenced and experimental conditions. A hand exercise program was performed and evaluated with hand force measurements, hand function test, patient relevant questionnaires (DASH and SF-36) and ultrasound measurements.

Results:

The new finger extension force measurement device was developed and then validated with measurements of accuracy as well as test-retest reliability. The coefficient of variation was 1.8 % of the applied load, and the test-retest reliability showed a coefficient of variation no more than 7.1% for healthy subjects. Ultrasound examination on m. extensor digitorum communis (EDC) showed significant differences between healthy men and healthy women as well as between healthy women and RA patients. The extension and flexion force improved in both groups after six weeks of hand exercise (p<0.01). Hand function improved in both groups (p<0.01). The RA group showed improvement in the results of the DASH questionnaire (p<0.05). The cross-sectional area of the EDC increased significantly in both groups.

Conclusions:

A new finger extension force measuring device has been developed which provides objective and reliable data on the extension force capacity of normal and dysfunctional hands and is sufficiently sensitive to evaluate the effects of hand exercise. US provide useful information about muscle architecture. A significant improvement of hand strength and hand function in RA patients was seen after six weeks of hand training, the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for RA patients, providing better strength and function.

Place, publisher, year, edition, pages
Göteborg: Göteborgs Universitet, 2008
Keywords
Muscles, Muscle rigity, Rheumatoid Arthritis, Exercise therapy
Identifiers
urn:nbn:se:hh:diva-5972 (URN)978-91-628-7602-9 (ISBN)
Public defence
2008-12-12, Aulan Sahlgrenska universitetssjukhuset/Sahlgrenska, Göteborg, 13:00 (English)
Opponent
Available from: 2010-09-23 Created: 2010-09-23 Last updated: 2018-03-23Bibliographically approved

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