The use of a combined, interdisciplinary, individual, one-session intervention was associated with significant improvement in grip strength and self-reported satisfaction compared with routine care plus placebo in patients with osteoarthritis (OA) of the hand, according to study results published in the journal Arthritis Research & Therapy.
The investigators conducted a 2-month randomized controlled trial with a blinded assessor to evaluate the effect of a combined interdisciplinary intervention that is feasible in both primary and specialist care vs routine care plus placebo in patients with hand OA. Participants were recruited from the rheumatology outpatient clinic of the Medical University in Vienna, Austria. In patients in the combined-intervention group, rheumatology-trained healthcare professionals from a variety of disciplines delivered a single-session individual intervention that included detailed information regarding functioning, activities of daily living, physical activity, assistive devices, nutrition, and instruction on pain management and exercises. Follow-up telephone calls were made 4 weeks after the intervention.
The primary study outcome was grip strength after 8 weeks. Secondary outcomes included self-reported pain, health status, satisfaction with treatment, total score on the Australian/Canadian Hand Osteoarthritis Index, and 2 of the Jebsen-Taylor Hand Function subtests.
A total of 151 patients participated in the analysis: 74 in the combined-intervention arm and 77 in the routine-care-plus-placebo arm. The 2-month follow-up attendance was 84% (128 of 151). Participants’ grip strength increased significantly in patients in the combined-intervention group and decreased in the routine-care group (P =.001) after 8 weeks. In fact, at the baseline assessment, 45% of patients in the routine-care arm and 43% of patients in the combined-intervention arm had a grip strength of 0. At the follow-up assessment, this number increased to 48% in the routine-care group but decreased to 23% in the combined-intervention group.
Significant improvements were reported in self-reported satisfaction with treatment and in the Jebsen-Taylor Hand Function subtests.
The investigators concluded that the use of a combined one-session intervention may be an effective, satisfying, time-efficient approach to be used in busy clinical settings in both primary and specialized care. The intervention can be delivered by rheumatology-trained nonphysician healthcare professionals.
Stoffer-Marx MA, Klinger M, Luschin S, et al. Functional consultation and exercises improve grip strength in osteoarthritis of the hand – a randomised controlled trial. Arthritis Res Ther. 2018;20(1):253.