Home exercises ‘effective’ at reducing rheumatoid arthritis hand problems

HOME hand exercises provide huge benefits for people with rheumatoid arthritis, researchers from the University of Salford have found.

In the first ever review of its kind, researchers found that home exercise programmes improved patients’ grip strength and hand movement while reducing the amount of pain they experienced, but that high-intensity programmes were the most effective.

Rheumatoid arthritis often causes problems such as pain, stiffness and joint swelling in the hands as an early symptom of the disease, with women’s grip strength reduced on average to less than half within six months of diagnosis.

These problems sometimes mean people are unable to carry on working while 59 per cent of people develop hand deformities within a decade of developing the condition.

Although medication can improve symptoms, it does not stop the loss of muscle function and occupational therapists and physiotherapists often teach home hand exercise programmes as a way of managing the illness – although the type of exercise and number of sessions varies widely. Little work has been done to assess how effective they can be.

Professor Alison Hammond and Dr Yeliz Prior from the University’s School of Health Sciences looked at home hand exercise trials involving 665 patients with an average age of 59.

They had taken part in a range of exercise programmes included squeezing, pinching and rolling therapeutic putty, squeezing hand exercise balls and pulling against resistance bands.

Their report, published in the British Medical Bulletin, concludes that those who had done exercises using therapeutic putty giving medium – or stronger –  resistance at high intensity did best. 

People regularly doing such exercises reported improvements in grip strength, hand movement and their ability to carry out everyday tasks, as well as experiencing less hand pain. Longer-term, if they keep doing them, these benefits continue.

Alison Hammond, Professor in Rheumatology Rehabilitation at the University of Salford, said: “Rheumatoid arthritis effects nearly 700,000 people in the UK, with many suffering hand problems which can be both agonising and can reduce their ability to work and carry out everyday tasks. We have found that hand exercise programmes are an effective way of reducing these problems, but that high intensity resistive exercises are by far the best and most cost-effective method.

“We found that the most effective programmes were high intensity and supervised by therapists for four or more sessions at first, to make sure people with arthritis can do the exercises right, steadily build up resistance and get into the habit of doing them. These resulted in consistent improvements. In comparison, low-intensity, low-resistance programmes, taught in just one session – which is common practice in the NHS – don’t produce these results.

“Our findings showed that people should do between four and six resistive hand exercises performed at high intensity – such as 10 repetitions of each exercise performed daily, and then up to three times a day as their hands improve. Although this takes 20 minutes or so a day, they can be spread through the day and easily done when taking a break or watching TV.”