THU0431 FREQUENCY OF TENDON INVOLVEMENT AND ITS EFFECT ON HAND FUNCTION IN HAND OSTEOARTHRITIS

Objective.To evaluate the effectiveness and tolerance of intraarticular injection (IAI) of triamcinolone hexacetonide (TH) for the treatment of osteoarthritis (OA) of hand interphalangeal (IP) joints.Methods.Sixty patients who underwent IAI at the most symptomatic IP joint were randomly assigned to receive TH/lidocaine (LD; n = 30) with TH 20 mg/ml and LD 2%, or just LD (n = 30). The injected joint was immobilized with a splint for 48 h in both groups. Patients were assessed at baseline and at 1, 4, 8, and 12 weeks by a blinded observer. The following variables were assessed: pain at rest [visual analog scale (VAS)r], pain at movement (VASm), swelling (physician VASs), goniometry, grip and pinch strength, hand function, treatment improvement, daily requirement of paracetamol, and local adverse effects. The proposed treatment (IAI with TH/LD) was successful if statistical improvement (p < 0.05) was achieved in at least 2 of 3 VAS. Repeated-measures ANOVA test was used to analyze intervention response.Results.Fifty-eight patients (96.67%) were women, and the mean age was 60.7 years (± 8.2). The TH/LD group showed greater improvement than the LD group for VASm (p = 0.014) and physician VASs (p = 0.022) from the first week until the end of the study. In other variables, there was no statistical difference between groups. No significant adverse effects were observed.Conclusion.The IAI with TH/LD has been shown to be more effective than the IAI with LD for pain on movement and joint swelling in patients with OA of the IP joints. Regarding pain at rest, there was no difference between groups. Trial registration number: ClinicalTrials.gov (NCT02102620).

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Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: A randomized controlled trial

Arthritis & Rheumatism ◽

10.1002/art1.10246 ◽

2002 ◽

Vol 47 (1) ◽

pp. 44-49 ◽

Cited By ~ 102

Author(s):

Tanja Alexandra Stamm ◽

Klaus Peter Machold ◽

Josef Sebastian Smolen ◽

Sabine Fischer ◽

Kurt Redlich ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Hand Function ◽

Hand Osteoarthritis ◽

Randomized Controlled ◽

Joint Protection ◽

Hand Exercises

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Hand exercise leads to modest improvement in grip and pinch strength, but no difference in hand function, pain, stiffness or dexterity in older people with hand osteoarthritis

Australian Occupational Therapy Journal ◽

10.1111/j.1440-1630.2009.00839_1.x ◽

2010 ◽

Vol 57 (1) ◽

pp. 68-69

Author(s):

Claire Ballinger ◽

Jo Adams

Keyword(s):

Older People ◽

Hand Function ◽

Pinch Strength ◽

Hand Osteoarthritis ◽

Modest Improvement

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Associations between hand function and electrophysiological measurements in hand osteoarthritis patients of different ages with or without carpal tunnel syndrome

Scientific Reports ◽

10.1038/s41598-020-74795-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Young Hoon Kim ◽

Eun Young Han ◽

Jinseok Kim ◽

Kyu-Bum Seo ◽

Young Tae Jeon ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Hand Function ◽

Sensory Nerve ◽

Male Gender ◽

Pinch Strength ◽

Hand Osteoarthritis ◽

Hand Grip ◽

Tunnel Syndrome

Abstract Osteoarthritis is a common degenerative disease that most frequently involves the hand. The objective was to compare clinical functional outcome measures including hand grip, pinch strength, and dexterity with various electrophysiological measures in patients of different ages with hand osteoarthritis with or without the presence of carpal tunnel syndrome (CTS). Patients with hand osteoarthritis (208 patients, 404 hands) who underwent hand-function tests and motor and sensory nerve conduction studies (NCS) between June 2015 and June 2016 were enrolled. The patients’ hands were assigned to carpal tunnel syndrome (CTS) (206 hands; mean age, 56.37 ± 10.52; male:female, 46:160) or control groups (198 hands; mean age, 57.88 ± 9.68; male:female, 55:143). The strength of hand grip and lateral pinch, the time required to complete the nine-hole pegboard test (9HPT), and motor and sensory nerve conduction parameters were measured and compared across age groups and between hands with or without CTS. The CTS group showed significantly lower hand grip and lateral pinch strength, and a longer time to complete the 9HPT in comparison with the control group. Female patients showed significantly lower hand grip and lateral pinch strength than male patients. However, there was no difference in the 9HPT completion time between genders. Multivariate regression analysis identified the amplitude of the median compound muscle action potential (CMAP), age, and male gender as independent predictors of grip strength (adjusted R2 = 0.679), and amplitude of median CMAP and male gender as independent predictors of KP strength (adjusted R2 = 0.603). Velocity of median CMAP, amplitude of median sensory nerve action potential, and age were identified as independent predictors of 9HPT time (adjusted R2 = 0.329). Nerve conduction measurements were significantly related to hand-function test results, and CTS induced significant deficits in strength and performance of the affected hand.

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The effects of resistance training on muscle strength, joint pain, and hand function in individuals with hand osteoarthritis: a systematic review and meta-analysis

Arthritis Research & Therapy ◽

10.1186/s13075-017-1348-3 ◽

2017 ◽

Vol 19 (1) ◽

Cited By ~ 17

Author(s):

Nicoló Edoardo Magni ◽

Peter John McNair ◽

David Andrew Rice

Keyword(s):

Systematic Review ◽

Resistance Training ◽

Muscle Strength ◽

Joint Pain ◽

Meta Analysis ◽

Hand Function ◽

Hand Osteoarthritis

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Measures of hand function: Arthritis Hand Function Test (AHFT), Australian Canadian Osteoarthritis Hand Index (AUSCAN), Cochin Hand Function Scale, Functional Index for Hand Osteoarthritis (FIHOA), Grip Ability Test (GAT), Jebsen Hand Function Test (JHFT)

Arthritis Care & Research ◽

10.1002/acr.20631 ◽

2011 ◽

Vol 63 (S11) ◽

pp. S189-S199 ◽

Cited By ~ 63

Author(s):

Janet L. Poole

Keyword(s):

Hand Function ◽

Hand Osteoarthritis ◽

Functional Index ◽

Ability Test ◽

Function Test

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Exercise for Hand Osteoarthritis: A Cochrane Systematic Review

The Journal of Rheumatology ◽

10.3899/jrheum.170424 ◽

2017 ◽

Vol 44 (12) ◽

pp. 1850-1858 ◽

Cited By ~ 7

Author(s):

Nina Østerås ◽

Ingvild Kjeken ◽

Geir Smedslund ◽

Rikke H. Moe ◽

Barbara Slatkowsky-Christensen ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Hand Function ◽

Joint Stiffness ◽

Risk Of Bias ◽

Finger Joint ◽

Hand Osteoarthritis ◽

Hand Pain ◽

Quality Evidence

Objective.To assess the benefits and harms of exercise compared with other interventions, including placebo or no intervention, in people with hand osteoarthritis (OA).Methods.Systematic review using Cochrane Collaboration methodology. Six electronic databases were searched up until September 2015. Inclusion criteria: randomized or controlled clinical trials comparing therapeutic exercise versus no exercise, or comparing different exercise programs. Main outcomes: hand pain, hand function, finger joint stiffness, quality of life, adverse events, and withdrawals because of adverse effects. Risk of bias and quality of the evidence were assessed.Results.Seven trials were included in the review, and up to 5 trials (n = 381) were included in the pooled analyses with data from postintervention. Compared to no exercise, low-quality evidence indicated that exercise may improve hand pain [5 trials, standardized mean difference (SMD) −0.27, 95% CI −0.47 to −0.07], hand function (4 trials, SMD −0.28, 95% CI −0.58 to 0.02), and finger joint stiffness (4 trials, SMD −0.36, 95% CI −0.58 to −0.15) in people with hand OA. Quality of life was evaluated by 1 study (113 participants) showing very low-quality evidence for no difference. Three studies reported on adverse events, which were very few and not severe.Conclusion.Pooled results from 5 studies with low risk of bias showed low-quality evidence for small to moderate beneficial effects of exercise on hand pain, function, and finger joint stiffness postintervention. Estimated effect sizes were small, and whether they represent a clinically important change may be debated.

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P081 Arthritis, artists and art opporunities for education

Rheumatology ◽

10.1093/rheumatology/keab247.079 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Soha Amar ◽

Mark Lloyd

Keyword(s):

Rheumatic Disease ◽

Therapeutic Potential ◽

Hand Function ◽

Hand Osteoarthritis ◽

Positive Effects ◽

Frida Kahlo ◽

Therapeutic Benefits ◽

Talented People ◽

Outdoor Scenes ◽

Rheumatic Conditions

Abstract Background/Aims The role of art in rheumatology is under-investigated. Several well-known artists have suffered from rheumatic disease. Their insights and achievements potentially provide reassurance and encouragement to our patients. Creating art may also offer therapeutic benefits for patients. Finally, the artistic environment can affect mood and behaviour. We highlight several inspirational artists. Methods Four artists offer valuable insights: Michaelangelo (d. 1564) was able to master sculpture, painting and architecture despite hand osteoarthritis and persisted in working until his death, age 89. Pierre-Auguste Renoir (d. 1919) developed severe RA aged 50. He continued to paint for the rest of his life, being carried to outdoor scenes on a sedan and designing an innovative rolling canvas to complete some of his finest work. He painted on small pieces of wood at night to distract from his arthritic pain. Frida Kahlo (d.1954), the Mexican artist, experienced chronic generalised pain and fatigue in keeping with fibromyalgia. This was after a bus accident at eighteen resulted in multiple pelvic and vertebral fractures. Self-portraiture became the cornerstone of her bold art during the solitude of her convalescence. Maud Lewis (d.1970), the Canadian folk painter, had JIA in early childhood resulting in a limp and severe hand changes. She spent much time indoors due to her pain and the ridicule faced from her peers. She developed an eagerness for drawing; to the extent that she painted on any surface she could find of her small cottage. Results These artists’ own words reveal the resilience they gained from their art. Renoir stated: 'Out of doom and misery the most beautiful song may rise'. Lewis reported ‘As long as I’ve got a brush in front of me, I’m alright.’, whilst Kahlo was similarly quoted to say ‘I am broken. But I am happy to be alive as long as I can paint’. A small study in 2017 with 17 patients with RA showed improvement not only in hand function but also self-perception and quality of life after participating in daily art-based intervention (origami, painting and clay modelling) for four weeks. Furthermore, a common theme between these famous artists was how they favoured bright colours in their artwork, which may have positive effects on mood. Colouring can reduce stress in children in paediatric waiting rooms. Within other settings, research suggests that visual art depicting nature can reduce anxiety in emergency department waiting rooms. Conclusion Although exceptionally talented people, the artists discussed show the inspiring possibilities of creativity despite severe rheumatic disease. We suggest sharing these stories with our patients and considering further study into the therapeutic potential of creating art in rheumatic conditions. Attention should be paid to the artistic environment in which we see our patients. Disclosure S. Amar: None. M. Lloyd: None.

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