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JOURNAL ARTICLE
REVIEW
SYSTEMATIC REVIEW
The effectiveness of home hand exercise programmes in rheumatoid arthritis: a systematic review.
British Medical Bulletin 2016 September
INTRODUCTION: Rheumatoid arthritis (RA) commonly reduces hand function. We systematically reviewed trials to investigate effects of home hand exercise programmes on hand symptoms and function in RA.
SOURCES OF DATA: We searched: Medline (1946-), AMED, CINAHL, Physiotherapy Evidence Database, OT Seeker, the Cochrane Library, ISI Web of Science from inception to January 2016.
AREAS OF AGREEMENT: Nineteen trials were evaluated. Only three were randomized controlled trials with a low risk of bias (n = 665). Significant short-term improvements occurred in hand function, pain and grip strength, with long-term improvements in hand and upper limb function and pinch strength.
AREAS OF CONTROVERSY: Heterogeneity of outcome measures meant meta-analysis was not possible.
GROWING POINTS: Evaluation of low and moderate risk of bias trials indicated high-intensity home hand exercise programmes led to better short-term outcomes than low-intensity programmes. Such programmes are cost-effective.
AREAS TIMELY FOR DEVELOPING RESEARCH: Further research is required to evaluate methods of helping people with RA maintain long-term home hand exercise.
SOURCES OF DATA: We searched: Medline (1946-), AMED, CINAHL, Physiotherapy Evidence Database, OT Seeker, the Cochrane Library, ISI Web of Science from inception to January 2016.
AREAS OF AGREEMENT: Nineteen trials were evaluated. Only three were randomized controlled trials with a low risk of bias (n = 665). Significant short-term improvements occurred in hand function, pain and grip strength, with long-term improvements in hand and upper limb function and pinch strength.
AREAS OF CONTROVERSY: Heterogeneity of outcome measures meant meta-analysis was not possible.
GROWING POINTS: Evaluation of low and moderate risk of bias trials indicated high-intensity home hand exercise programmes led to better short-term outcomes than low-intensity programmes. Such programmes are cost-effective.
AREAS TIMELY FOR DEVELOPING RESEARCH: Further research is required to evaluate methods of helping people with RA maintain long-term home hand exercise.
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