Long Term Strength Training Improves Grip Strength and Pain in Older Adults with Hand Osteoarthritis

Abstract

Hand osteoarthritis (HOA) is common in older adults. It often results in pain, joint deformities, reduced grip and pinch strength, and functional impairments. Few interventional exercise studies have been conducted in this area. PURPOSE: To determine the effects of 24 months of whole body strength training, including a gripper exercise, on grip strength, pain, and function in adults with HOA. METHODS: In a group with radiographic HOA participating in a strength training study, self-reported hand function (AIMS2), hand pain (0-10 analog scale), maximum isometric grip strength, and weight used during a plate loaded isotonic gripper exercise were recorded. Position 3 on the grip dynamometer was used for isometric testing. Participants (N = 55; 71.5 + 6.5 years; 80% female) completed an institute based whole body strength training regimen with a fitness trainer three times per week, performing three sets of 10 to 15 repetitions at near maximal effort. Upper extremity exercises, performed on weight stack machines, included seated chest press, lat pulldown, biceps curl, triceps push-down, seated row, and shoulder press. A brief aerobic warm-up and cool-down bracketed each training session. A subgroup (n = 29) of participants with complete maximum isometric grip strength data was also analyzed, along with a further subgroup with symptomatic HOA (n = 13), denned as baseline hand pain of 3 or higher. RESULTS: Bilateral 15-repetition gripper exercise weight improved 1.94 kg (p < 0.0003) between baseline and 24 months. Right isometric grip improved 3.62 kg (p < 0.0015) and left 2.95 kg (p < 0.0005) at follow-up in the sub-group. In the symptomatic HOA sub-group, hand pain was reduced from 4.77 to 2.62 (p < 0.0056). There were no significant differences in AIMS2 hand function scores for either the whole group or the symptomatic sub-group at follow-up. However, mean scores showed little hand dysfunction at baseline, creating a floor effect. CONCLUSIONS: This study demonstrates that long term strength training which includes a dynamic gripper exercise improves static and dynamic grip strength in older persons with radiographic hand OA, and reduces pain in persons with symptomatic hand OA.