There is emerging high-quality evidence to support that rehabilitation interventions can offer significant benefits to individuals with hand osteoarthritis (OA), say authors of a meta-analysis published online ahead of print February 18 in Arthritis Research & Therapy.
Researches performed a computerized literature search of Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ISI Web of Science, the Physiotherapy Evidence Database (PEDro), and SCOPUS. Studies that had an evidence level of 2b or higher and that compared a rehabilitation intervention with a control group and assessed at least 1 outcome measure (eg, pain, physical hand function, or other measures of hand impairment) were included. The eligibility and methodological quality of trials were systematically assessed by 2 independent reviewers using the PEDro scale. Treatment effects were calculated using standardized mean difference and 95% confidence intervals.
Ten studies, of which 6 were of higher quality (PEDro score >6), were included. The rehabilitation techniques reviewed included 3 studies on exercise, 2 studies each on laser and heat, and 1 study each on splints, massage, and acupuncture. One higher quality trial showed a large positive effect of 12-month use of a night splint on hand pain, function, strength, and range of motion. Exercise had no effect on hand pain or function although it may be able to improve hand strength. Low-level laser therapy may be useful for improving range of motion. No rehabilitation interventions were found to improve stiffness.