Hand Exercise Research Articles

Differences in brain activation and connectivity during unaffected hand exercise in subacute and convalescent stroke patients

Differences in brain activation and connectivity during unaffected hand exercise in subacute and convalescent stroke patients

A Study of Exergame System Using Hand Gestures for Wrist Flexibility Improvement for Tenosynovitis Prevention

Currently, as an increasing number of people have been addicted to using cellular phones, smartphone tenosynovitis has become common from long-term use of fingers for their operations. Hand exercise while playing video games, which is called exergame, can be a good solution to provide enjoyable daily exercise opportunities for its prevention, particularly, for young people. In this paper, we implemented a simple exergame system with a hand gesture recognition program made in Python using the Mediapipe library. We designed three sets of hand gestures to control the key operations to play the games as different exercises useful for tenosynovitis prevention. For evaluations, we prepared five video games running on a web browser and asked 10 students from Okayama and Hiroshima Universities, Japan, to play them and answer 10 questions in the questionnaire. Their playing results and System Usability Scale (SUS) scores confirmed the usability of the proposal, although we improved one gesture set to reduce its complexity. Moreover, by measuring the angles for maximum wrist movements, we found that the wrist flexibility was improved by playing the games, which verifies the effectiveness of the proposal.

Gujarati translation and adherence testing of Stretching and Strengthening of Rheumatoid Arthritis of the Hand (SARAH)

ABSTRACT Context: Stretching and strengthening for rheumatoid arthritis of the hand (SARAH) is a progressive and individually designed recommended treatment exercise program. Aims: The aim was to translate the SARAH hand exercise program into Gujarati and assess the adherence rate, usefulness, and understanding of the Gujarati SARAH exercise program. Methods and Materials: Mixed-method qualitative study was conducted among 25 participants at the outpatient departments of Institute Nadiad and Niruj Rheumatology Clinic, Gujarat, and via professional contact, a telephonic semi-structured interview was conducted among 13 participants using an interview guide, and interviews were audio-recorded following transcription verbatim. Overall adherence rates of 25 participants to a 12-week exercise program were determined using the cross-sectional method. Statistical Analysis Used: IBM SPSS software version 23.0 was used for analyzing quantitative data, and NVivo Plus version 11 was used for qualitative data. Results: The adherence rate was 97.22%. Participants completed all 72 sessions (n = 7) with an adherence rate of 100%. The least number of sessions completed was 25 (n = 2), with an adherence rate of 34% due to a lack of interest in exercising on a daily basis. Qualitative findings showed that the booklet is understandable, useful, and beneficial in terms of reducing symptoms and improving activities of daily life as well as occupational work. Conclusion: The translated strengthening and stretching for rheumatoid arthritis in the hand exercise booklet is effective and beneficial to patients who exercise at home. Participants can self-track their exercise by using dairy, which eliminates travel costs and attendance at clinic sessions.

Nonoperative Management of Trapeziometacarpal Joint Arthritis: A Systematic Review of the Clinical Trials.

This systematic review evaluates nonoperative treatments for trapeziometacarpal joint osteoarthritis (TMJO), a common degenerative condition in postmenopausal females causing pain, reduced mobility, and diminished grip strength.Following PRISMA guidelines, a search was conducted across PubMed, Cochrane, Embase, and MEDLINEfor randomized controlled trials (RCTs) assessing pain outcomes with nonoperative interventions over at least a six-month follow-up, using the visual analog scale (VAS) for pain measurement. Eleven RCTs yielded moderate-quality evidence for the following: (1) corticosteroid (CSI) and hyaluronic acid (HA) injections exhibit comparable mean delta pain scores after six months, with CSI offering early relief at two to three weeks. After 12 months, CSI led to a continued decrease in pain, with a mean delta pain score of 1.0 (p<0.05), contrasting with hyaluronic acid (HA) injections, which presented a modest though nonsignificant improvement, demonstrating a mean delta pain score of 0.5 (p=0.16). (2) Relatively novel therapies for TMJO, such as platelet-rich plasma (PRP) and dextrose, appear to surpass CSI in long-term effectiveness, with dextrose showing a mean delta pain score of 3.8 (p<0.001) at six months and PRP achieving a mean delta pain score of 5.5 (p=0.005) at 12 months. (3) Various hand therapies, notably standard hand exercises and extracorporeal shockwave therapy (ESWT), demonstrated significant pain reduction, with the former achieving a mean delta pain score of 1.5 (p=0.019) and the latter a score of 4.2 (p<0.001). (4) The use of orthoses substantially decreases pain levels, demonstrating a mean delta pain score reduction of 2.6 at a 180-day follow-up (p=0.023) and 2.2 at a 12-month follow-up (p=0.002). In conclusion, nonoperative treatments for TMJO, including intra-articular injections, hand therapy, and orthoses, provide significant pain relief at a minimum of six months follow-up. The synergistic effect of combined nonoperative management, as well as the effect size of each, is unknown.

Exoskeleton-assisted upper limb rehabilitation after stroke: a randomized controlled trial

ABSTRACT Objectives The upper-limb exoskeleton training program which is repetetive and task-specific therapy can improve motor functions in patients with stroke. To compare the effect of an upper-limb exoskeleton training program with Bobath concept on upper limb motor functions in individuals with chronic stroke. Methods Participants were randomly assigned to exoskeleton group (EG, n = 12) or to Bobath group (BG, n = 12). Interventions were matched in terms of session duration and total number of sessions and performed 2 times per week for 6-weeks. Primary outcome was Fugl-Meyer- Upper Extremity (FMA-UE). Secondary outcomes were Modified Ashworth Scale (elbow and wrist flexor muscles), Motor Activity Log-30 which is consist of two parts as an amount of use (AOU) and quality of movement (QOM), and The Nottingham Extended Activities of Daily Living (NEADL) index. Results After 12-sessions of training, the mean (SD) FMA-UE score increased by 5.7 (2.9) in the EG, and 1.9 (1.5) points in the BG (p < .05). In total, 40% of participants (5/12) demonstrated a clinically meaningful improvement (≥5.25 points) in the FM-UE, while none of the participants reached MCID score in the bobath group. Changes in the AOU, QOM, and NEADL were significantly larger in the EG compared to BG (p < .05). 7/12 (58.33%) of participants for AOU and 5/12 (42%) of participants for QOM in the EG showed that clinically meaningful change. 5/12 of participants (42%) in the EG demonstrated ≥4.9-point increase in NEADL score. Discussion High-intensity repetitive arm and hand exercises with an exoskeleton device was safe and feasible. Exoskeleton-assisted training demonstrated significant benefits in improving upper limb functions and quality of life in individuals after stroke.

Personalized Daily Hand Movement Training Methods and Effects: A Case Study

This study proposes a method for personalized daily hand exercise training to address the lack of personalization in rehabilitation training and its disconnect from daily life. This research aims to evaluate the impact of Happiness Memory Therapy on patients’ hand function through gamified daily life training. The methodology integrates Happiness Memory Therapy and Positive Mirror Theory to assist in life game design. Patient interviews and empathy are used to gather life experiences, interests, hobbies, and challenges, which are then incorporated into personalized rehabilitation training. The experimental process includes pre- and post-intervention tests to assess changes in subjective well-being (SWLS), happiness (SHS), positive and negative emotions (PANAS), psychological well-being (PWB), and hand function impairment (DASH). The results show that the intervention significantly enhances patients’ subjective well-being, happiness, positive emotions, and reduces negative emotions and hand function impairments. In conclusion, Happiness Memory Therapy and Positive Mirror Theory are effective in developing personalized daily hand exercise training methods and have a significant impact on improving the psychological health and quality of life of stroke patients, offering new ideas and methods for personalized rehabilitation training.

Efficacy of Hand and Eye Coordination Exercises with Cleft Palate Surgical Simulator

Efficacy of Hand and Eye Coordination Exercises with Cleft Palate Surgical Simulator

Investigation of sensory and motor functions of wrist in patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is a systemic and autoimmune disease that affects many tissues and organs in the body, especially the synovial joint and periarticular structures. One of the most affected joints is the hand joints, and there is also involvement in the wrist joint. ObjectivesThe purpose of this study was to assess the sensory and motor functions of the wrist with a gold standard method and to determine the relationship between the motor and sensory functions of the wrist and wrist-related pain/disability level and hand grip strength in patients with RA. MethodFlexor and extensor muscle strength and joint position sense of the wrist were evaluated using isokinetic dynamometer, hand grip strength was measured using dynamometer, and wrist related pain and disability was assessed by Patient Rated Wrist Evaluation (PRWE) questionnaire. ResultsThirty-one patients with RA and 31 healthy controls were included in the study. Control group had better results regarding wrist flexor and extensor muscle strength and wrist joint position sense than RA patients for both hands/wrists. A positive and strong correlation and a negative and weak correlation were found between muscle strength and joint position sense of the wrist and hand grip strength, respectively. ConclusionsCompared to healthy subjects, RA patients showed wrist-related sensorimotor deficits. Therefore, evaluation of the wrist should not be ignored in the examination of patients with RA. In addition, when planning the treatment program of the patients, not only hand exercises but also exercises involving the wrist should be taken into consideration.

Effect of Combined Neck, Shoulder and Hand Exercises with Conventional Physiotherapy Treatment on Hand Grip Strength and Hand Function in Patients with Unilateral Cervical Radiculopathy: a Comparative Study

Effect of Combined Neck, Shoulder and Hand Exercises with Conventional Physiotherapy Treatment on Hand Grip Strength and Hand Function in Patients with Unilateral Cervical Radiculopathy: a Comparative Study

Do Hand Exercises Influence Physiological Hand Tremor? An Observational Cohort Study on Healthy Young Adults

Physiological hand tremors appear to be one of the most common types of tremors that occur during the lifespan. Activities most prominently affected by hand tremors are those involving the movement of small muscles, such as fine motor skills, which in turn could be influenced by several factors, including lateral dominance. The difference in skills due to lateral dominance is defined as inter-limb imbalance or inter-limb asymmetry. When this asymmetry is attributed to the tremor and the difference in tremor between the limbs, it could be defined as the inter-limb asymmetry of tremors. This study aimed to evaluate the acute effects of wobble-board hand exercise training on the inter-limb asymmetry of tremors. Thirty-two (eighteen males and fourteen females) participants (age: 25.2 ± 2.6 years, weight: 63.9 ± 10.5 kg, height: 1.66 ± 0.8 m, and BMI: 22.8 ± 2.3 kg/m2) were involved in the study. Before (PRE) and after (POST) the wobble-board hand exercises, postural hand tremor was evaluated using a tri-axial accelerometer fixed under the palm. Recordings were taken for 15 s. One-way Analysis of Variance (ANOVA) was used to examine the effects of hand exercises on inter-limb (dominant vs. non-dominant) asymmetry of tremor in testing time (PRE vs. POST) in relation to sex (male vs. female). The statistical significance was set at p &lt; 0.05. Significant differences were found in physiological hand tremors between limbs (dominant vs. non-dominant) in the PRE evaluation (p = 0.03) independently from sex while no differences were found in the POST evaluation. A significant difference emerged in the PRE evaluation for males (p = 0.04) and females (p = 0.03) in relation to the testing time and preferred hand. This difference was no longer present in the POST evaluation. In conclusion, wobble-board hand exercises could represent an effective strategy to reduce inter-limb asymmetry. These results emphasize the importance of task-specific training to maximize the reduction in inter-limb asymmetry of tremors following wobble-board hand exercises.

Study On the Impact of Hand Exercise on The Cognitive Function of The Elderly Brain

This study aims to evaluate the impact of unarmed strength training on the cognitive function of middle-aged and elderly patients with mild cognitive impairment (MCI). The study subjects are 60 elderly male MCI patients from the Community Health Service Center in Hangzhou, with an age range of 66±5 years. The participants were randomly divided into two groups: the control group and the intervention group. The control group did not receive any intervention measures, while the intervention group underwent a 12-week unarmed strength training program. Before and after the study, the Montreal Cognitive Assessment Scale (MoCA) was used to assess the changes in cognitive function of the subjects. The data analysis was conducted using SPSS 23.0 software, and t-tests and chi-square tests were used for inter-group comparisons based on the distribution characteristics of the data. After 12 weeks of unarmed training, the MoCA score of the intervention group at T2 was significantly higher than that of the control group (P&lt;0.05), indicating that the cognitive function of the intervention group had significantly improved. Unarmed strength training has a positive impact on the cognitive function of middle-aged and elderly MCI patients, and a 12-week training program can effectively improve the cognitive ability of this group.

Duration and severity of COVID-19 symptoms among primary healthcare workers: A cross-sectional survey.

This study aims to investigate the epidemiological characteristics of COVID-19 infection among healthcare workers, including the severity, duration of infection, post-infection symptoms and related influencing factors. A self-administered questionnaire was utilized to assess the post-infection status of primary healthcare workers in Jiangsu Province. The questionnaire collected information on demographic characteristics, lifestyle habits, post-infection clinical manifestations, work environment and recovery time of the respondents. Customized outcome events were selected as dependent variables and logistic regression models were employed to analyse the risk factors. Phi-coefficient was used to describe the relationship between post-infection symptoms. The analysis revealed that several factors, such as female, older age, obesity, previous medical history, exposure to high-risk environments and stress, were associated with a higher likelihood of experiencing more severe outcomes. On the other hand, vaccination and regular exercise were found to contribute to an earlier resolution of the infection. Among the post-infection symptoms, cough, malaise and muscle aches were the most frequently reported. Overall, there was a weak association among symptoms persisting beyond 14 days, with only cough and malaise, malaise and dizziness and headache showing a stronger correlation. The study findings indicate that the overall severity of the first wave of infection, following the complete lifting of restrictions in China, was low. The impact on primary healthcare workers was limited, and the post-infection symptoms exhibited similarity to those observed in other countries. It is important to highlight that these conclusions are specifically relevant to the population infected with the Omicron variant. This study helps to grasp the impacts of the first wave of COVID-19 infections on healthcare workers in China after the national lockdown was lifted. Primary healthcare workers in Jiangsu Province, including doctors, nurses, pharmacists and other personnel from primary healthcare units such as community health service centres and health centres.

P005 Early inflammatory arthritis combined nurse and therapist clinic

Abstract Background/Aims NICE guidelines recommend patients have ongoing access to a multidisciplinary team (MDT). However, ensuring all patients are seen by physiotherapy, podiatry, and occupational therapy (OT), when needed, can be challenging. The aim of the project was for patients to be seen by a therapist, in the first six months of their disease. The plan was to provide treatment and encourage long-term self-management, by providing knowledge of when self-referring to the different therapy services would be beneficial. Methods A Nurse and therapist pilot clinic was implemented at the first Disease Modifying Anti-Rheumatic Drugs review appointment. The clinic allowed 15-minutes with a specialist nurse to discuss medication issues and drug counselling. This was followed by 30-minutes with a therapist, to discuss any functional needs and objectively assess any joint issues and to provide treatment. Patients were educated about their condition and signposted to information. Patients were also provided with self-management advice and informed about the role of MDT members. Written or emailed advice was provided. Patients were invited to complete an anonymous questionnaire evaluating their experience. Results 60 patients were seen in the first three months. Personalised therapy input was given to each patient; however, hand exercises and joint protection advice was given to over 60% of patients. Other therapy input included exercises for other specific joints that were problematic, the provision of wrist splints and relaxation advice. Results of the patient questionnaire showed 98% of patients felt they ‘definitely’ had more information to help manage their arthritis and 100% felt they knew where to go to get more information, if needed. Patients also had a greater understanding of the role of physiotherapy and OT. 88% of patients were confident they would ‘definitely’ know when to ask to be referred to these specialities in the future. Less than 15% of patients required further therapy input following the appointment. Conclusion The pilot clinic received excellent patient feedback and fulfilled the aims of providing therapy input, early in patient’s journey. Patients liked the convenience of seeing both the professionals in one visit, felt they had gained more information on their condition and were able to help themselves. Patient’s comments included ‘feeling more supported’ and ‘being able to help myself’. One experienced therapist seeing the patients was more cost effective than separate physiotherapy and OT appointments. The next stage will be to invite all newly diagnosed patients into this clinic as part of an early inflammatory arthritis pathway. We will then audit the impact on therapy referral rates and assess if early intervention reduces the number of therapy referrals long-term, encourages patient self-management and improves patient outcomes. Disclosure H. Harrison: None. R. Allan: None.

The Effectiveness of Hand Exercise on Limb Function in Patient Coronary Artery Disease Posttransradial Artery Catheterization: Systematic Review

Coronary Artery Disease (CAD) is leading cause of mortality worldwide. Catheterization using the transradial arterial (TRA) technique has been able to reduce morbidity and mortality rates from CAD, but this procedure also contributes to the occurrence of complications. The aim of this study was to search literature and analyse articles discussing the use of hand exercise on improving limb function in patients posttransradial cardiac catheterization. Methods: The design used was a systematic review with PRISMA adaptation. Articles were searched using databases: ScienceDirect, ProQuest, PubMed, Scopus and Hand Searching in Google Scholar. The keywords of article search were using “Coronary artery disease” AND “transradial artery catheterization” OR “Trans cardiac Catheterization” AND “hand exercise” AND “limb function. In the initial stage of information search on 5 October 2023, the total number of articles obtained before selection was carried out based on inclusion and exclusion criteria was 7273 articles. From the five databases used, selection was then carried out according to the inclusion and exclusion criteria. The inclusion criteria were research articles published in the last 10 years (2013-2023); use English; a journal article and open access; Involves adult respondents and full text articles. Exclusion criteria were encyclopedia articles, book chapters, conferences, correspondence, editorials, news, practice guidelines, protocols, systematic reviews, literature reviews and meta analysis. The results are discussing 7 articles published from 2013-2023. Conclusions Hand exercises are useful for restoring limb function within two hours after the procedure and over a long period of time.

A Hand Gesture-Operated System for Rehabilitation Using an End-to-End Detection Framework

We propose a hand gesture-operated system as an AI application to relieve discomfort and restore function in hand and arm movements caused by injuries and nerve and muscle complications. The system trains patients with hand exercises, such as performing hand gestures accurately, traversing within specified bounds, and operating a hand gesture calculator. However, the system requires accurate hand gesture detection, which is impeded by background clutter and variations in illumination and in the hand's size and angle. To address this, we developed a robust hand detection module that uses a single-stage transformer deep network. The transformer network encodes global information and uses bipartite matching to reduce the frequency of spurious detections. It drives a regression head and a classification head to localize the hand gesture in a bounding box and assign it a class label. Hand keypoints are also detected to support drawing, path traversal, and calculator use. The approach is evaluated on two benchmark datasets: OUHANDS and NUS. The method yields 89.6% accuracy for OUHANDS and 100% for NUS. These results indicate that precise hand detection can support a robust system for rehabilitation through hand exercises. Our experiments confirm that the users' hand function progressively improved.

Case Report of Cylindrical Grip on Improving Upper Limb Muscle Strength of SNH Patient

Non-hemorrhagic stroke patients who do not get optimal treatment will experience disability or physical weakness such as paralysis and weakened muscle strength, which results in a lack of joint range of motion, limb function, and decreased daily life activities. One of the ROM techniques to help recover the upper extremities to stimulate the hands, can be done with cylindrical grip exercises which are functional hand exercises by grasping a cylindrical object in the palm of the hand which aims to support the recovery of the ability to move and function of the hand. Objective: This case repost aims to determine the effect of giving cylindrical grip to stroke ptients to increase muscle strengt in the upper extremities. Method: The method used is a descriptive case report design based on Evidance Based Nursing (EBN) conducted on two subjects with non-hemorrhagic stroke. Results: After the implementation of ROM exercise nursing: cylindrical grip for 3 days in each patient starting from 18-22 September 2023 which was carried out for 5 minutes and repeated 7 times, changes were obtained in the muscle strength of Mrs.M's right hand which was originally 3 to 4 and Mr.W which was originally left hand muscle strength 2 to 4. Conclusions: ROM Exercise: Cylindrical grip can improve upper extremity muscle strength in non-hemorrhagic stroke patients.

Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics.

Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy, which causes numbness and pain in the thumb, the index and middle fingers and the radial side of the ring finger. Regular hand exercises may improve the symptoms and prevent carpal tunnel surgery. This study applied a novel ultrasonic stimulation method to test tactile sensitivity in CTS and also a mixed-reality-assisted (MR-assisted) exercise program which measured hand movements and provided haptic feedback for rehabilitation. Twenty patients with mild unilateral CTS took part in the experiments. A mid-air haptics device (Ultrahaptics STRATOS Explore) was used to apply amplitude-modulated ultrasound waves (carrier frequency: 40 kHz) onto the skin to create tactile stimulation mechanically. Participants performed a two-alternative forced-choice task for measuring tactile thresholds at 250-Hz modulation frequency. They were tested at the index fingers and the thenar eminences of both hands. Additionally, 15 CTS patients used an MR-assisted program to do hand exercises with haptic feedback. Exercise performance was assessed by calculating errors between target and actual hand configurations. System Usability Scale (SUS) was adopted to verify the practical usability of the program. Thresholds at the thenar eminences of the affected and healthy hands were not significantly different. While the thresholds at the healthy index fingers could be measured, those of the affected fingers were all higher than the stimulation level produced by the maximum output from the ultrasound device. In the exercise program, a significant positive correlation (ρ = 0.89, p < 0.001) was found between the performance scores and the SUS scores, which were above the criterion value established in the literature. The results show that thenar tactile sensitivity is not affected in mild CTS as expected from the palmar cutaneous branch of the median nerve (PCBm), but index finger threshold is likely to be higher. Overall, this study suggests that mid-air haptics, with certain improvements, may be used as a preliminary test in the clinical setting. Moreover, the device is promising to develop gamified rehabilitation programs and for the treatment follow-up of CTS.

Pandemics and Climate Change as Systemic Risks: Law, Policy, Insurance, Physical Activity and Exercise as Mitigating Environmental Degradation Mechanisms

Climate change and the Covid-19 pandemic have been classified as systemic risks and have elaborated that such systemic risks will become the new normal. Ways to tackle the long-term effects of climate change include law and environmental policy. In addition, insurance can help mitigate the burden placed on governments when such systemic risks occur, including pandemics. In relation to the Covid-19 pandemic and the effects of long-Covid, sports and exercise are examined as a mitigating factor able to release pressure from public health and help mitigate its long-term effects. This article discusses the correlation of Covid-19 with environmental changes and climate changes and goes on to address the role of insurance, on the one hand and sports and exercise on the other hand as mitigating mechanisms to handle systemic risks such as climate change and pandemics. The article’s findings suggest and conclude that 1) outside state action (law and policy), private action such as change in lifestyle towards a more sustainable way of life, and sports and exercise can help with the long-term effects of pandemics and 2) insurance can act as a mitigating private sector mechanism. Governments should integrate law, policy, and mitigating techniques such as private insurance to tackle and respond to systemic risks. climate change, Covid-19, systemic risks, insurance, physical exercise, mitigation for climate change, mitigation, public health

Leveraging Coffee Waste for Social Impact: A Sustainable Toolkit for Enhancing Sensory Skills and Therapeutic Exercises in Educational and Therapeutic Settings

In an era of increasing focus on sensory development, mental well-being, and sustainability, we present herein a Coffee-Infused Soap-Making Toolkit as an innovative solution to the intersecting challenges born out of these factors. This study aims to develop and assess a novel toolkit designed to integrate sensory stimulation with therapeutic hand exercises while promoting sustainable practices. The problem addressed is a gap in the literature regarding educational and therapeutic tools that are effective and eco-friendly, which simultaneously support sensory and cognitive development. The research employs a descriptive design which is intended to be carried out with a sample of 100 participants, including children with sensory processing issues, older adults with motor function decline, and educators. Data collection will involve both quantitative and qualitative methods, utilizing surveys, structured interviews, and observational data to evaluate the toolkit’s impact on sensory engagement, motor function improvement, and overall well-being. Statistical and thematic analyses will be applied to interpret the data. The aim of this intended research is to determine whether the Coffee-Infused Soap-Making Toolkit, which aligns with sustainable practices by incorporating eco-friendly materials, effectively enhances sensory skills and motor functions by leveraging the tactile and olfactory benefits of coffee grounds, as well as its effectiveness in supporting therapeutic hand exercises. This study underscores the potential of integrating sensory enrichment with sustainability in educational and therapeutic settings, offering practical implications for educators and therapists. The toolkit is not only designed to foster cognitive and motor development, but also exemplifies how environmental responsibility can be embedded into therapeutic interventions. Future research should focus on empirical validation across diverse populations and explore the broader implications of sustainable practices in therapeutic tools.

Therapeutic Putty-based Hand Strengthening Exercises to Improve Hand Function and Quality of Life in Patients with Chronic Rheumatoid Arthritis

Context: Rheumatoid arthritis (RA) primarily affects the hands, leading to disabling joint abnormalities and reduced muscle strength, profoundly impacting hand function and overall quality of life (QOL). Aim: The aim of this study was to find the effect of therapeutic putty-based hand exercises on hand function and QOL in patients with chronic RA. Setting and Design: It was an experimental study conducted at the College of Physiotherapy, Pt. B.D. Sharma, PGIMS, Rohtak. Subjects and Methods: In this study, 206 chronic RA patients were randomly split into two groups. Group A (control) received conventional physiotherapy care including hot fomentation, joint protection advice, active exercises, and splinting. Group B (experimental) engaged in hand strengthening exercises with 85 g of therapeutic putty alongside conventional physiotherapy. Key outcomes assessed grip and key pinch strength, hand function (Short Form of the Score for the Assessment and Quantification of Chronic Rheumatic Affections of the Hands), and QOL (WHO-BREF) at baseline, 4th, 8th, and 12th weeks. Statistical Analysis: Effect of treatment comparison was done with one-way analysis of variance followed by post hoc analysis. Results: The experimental group showed superior outcomes for grip, key strength, and hand function (P = 0.000). Regarding the QOL, improvements were observed in the physical component at the 4th week (P = 0.003) and in both the 8th and 12th weeks (P = 0.000). The psychological, social, and environmental components improved significantly in the 8th and 12th weeks (P &lt; 0.005). Conclusion: A therapeutic putty-based strength training program as an addition to usual care is a worthwhile, low-cost intervention that helps improve function, disability, and QOL.