medwireNews: A single-session nonpharmacologic intervention delivered by rheumatology-trained healthcare professionals from different disciplines improves grip strength among patients with hand osteoarthritis, randomized trial findings suggest.
The intervention included strengthening and mobility exercises and a consultation about daily functioning, as well as information on physical activity, nutrition, bodyweight, and assistive devices, and was delivered two healthcare professionals comprising an occupational therapist, a physiotherapist, a nurse, and/or a dietician. Patients received follow-up telephone consultations after the face-to-face intervention, and could contact their healthcare providers via email or telephone at any time during the 2-month study.
The 59 participants who were randomly assigned to receive the interdisciplinary intervention experienced a significant improvement in grip strength in the dominant hand, from an average of 0.14 bar measured on a vigorimeter at baseline to 0.17 bar at the 8-week follow-up (mean difference=0.03 bar).
By comparison, the 69 patients allocated to receive usual care plus a massage ball experienced an average 0.03-bar deterioration in grip strength over the same timeframe, from a baseline measure of 0.13 bar.
Tanja Stamm (Medical University of Vienna, Austria) and study co-authors note that “[t]he difference in grip strength compared to baseline in the intervention group was smaller than expected,” but believe their findings are clinically significant because “grip strength deteriorated in the control group over the time period more than it improved in the intervention group,” and nonpharmacologic rehabilitation interventions “in general produce small effects.”
Moreover, they suggest that an intervention with a low but acceptable degree of efficacy “may be used to stabilize rather than to largely improve grip strength.”
The researchers also demonstrated that the proportion of patients with a grip strength measure of zero decreased from 43% at baseline to 23% at the 8-week follow-up among those who received the intervention, but increased from 45% to 48% in the control group.
And they report that patient-reported treatment satisfaction improved to a significantly greater degree among patients given the intervention compared with those in the control group, with average improvements of 3.50 versus 0.92 points on a Likert scale from 0 to 10.
Stamm and team conclude in Arthritis Research & Therapy that their intervention “may be an effective and satisfying time-efficient approach in busy clinical settings in both primary and specialised care, which can be delivered by rheumatology-trained non-physician health professionals.”
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