Effects of Hand Strengthening Exercise on Various Hand Functions in Female Patients of Chronic Rheumatoid Arthritis: A Case-control Study

Abstract

Introduction: Rheumatoid Arthritis (RA) is a chronic systemic inflammatory disease which hampers the physical activity of an individual due to presence of pain, stiffness and fatigue. As it is progressive in nature, regular exercise of sufficient intensity is needed to maintain muscle strength. Aim: To find the effectiveness of hand strengthening exercise programme with therapeutic putty on grip strength and functional movement in chronic rheumatoid hand. Materials and Methods: A total of 206 female patients of chronic RA female patients were randomly divided in two groups- control and experimental groups and data. Control group received care which included active hand exercises with hot water fomentation while experimental group received strengthening exercises with therapeutic putty and hot water fomentation. Grip strength was measured by hand dynamometer, key pinch strength of dominant hand was measured by digital pinch meter, pain severity was assessed by Brief pain inventory scale and hand function was measured by SF-SACRAH (Score for Assessment and Quantification of Chronic Rheumatic Affections of Hands) at 0 week, after 4 week, 8 week and 12 week for both groups. Treatment effects were compared by one-way ANOVA followed by post-hoc analysis. The results were analysed by Statistical Package for Social Sciences (SPSS) version 16.0. Results: After 12 weeks of exercise programme, a significant improvement (p<0.01 and p<0.005) were observed in all outcome measures of hand function including reduction in pain severity score from baseline in experimental group. While in control group there was no significant changes in all four parameters from baseline to after 12 week exercise programme. Conclusion: A significant improvement was seen in experimental group as compared to control group after hand strengthening exercise protocol using therapeutic putty suggesting that, hand strengthening exercise programme by using therapeutic putty is effective in chronic RA hand.