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Clin Rehabil. 2018 Nov;32(11):1449-1471. doi: 10.1177/0269215518780973. Epub 2018 Jun 18.

The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis.

Author information

1
1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
2
2 School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada.
3
3 Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
4
4 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
5
5 Occupational Therapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
6
6 Research Center on Aging, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada.
7
7 The Ottawa Hospital, Ottawa, ON, Canada.
8
8 Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, Faculty of Medicine and School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
9
9 School of Rehabilitation, University of Montréal, Montréal, QC, Canada.
10
10 National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
11
11 Department of Medicine, Queen's University, Kingston, ON, Canada.
12
12 School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
13
13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada.
14
14 Evidence-based Health Department, Federal University of Sao Paulo, Sao Paulo, Brazil.
15
15 Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
16
16 Department of Physical Education and Sport, University of Cadiz, Cadiz, Spain.
17
17 National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
18
18 Department of Medicine, Queen's University, Kingston, ON, Canada.
19
19 Hand Center, Centre Hospitalier de l'Université de Montréal and School of Rehabilitation, Faculty of Medicine, Université de Montréal, QC, Canada.
20
20 Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada.
21
21 Division of Rheumatology, University of Toronto, Toronto, ON, Canada.
22
22 School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
23
23 The Arthritis Society, Ottawa, ON, Canada.
24
24 Mary Pack Arthritis Program, Vancouver Coastal Health and Centre for Hip Health and Mobility and Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
25
25 Canadian Forces Health Services Group, National Defense, Ottawa, ON, Canada.
26
26 Consumer Expert.

Abstract

OBJECTIVE::

To identify programmes involving therapeutic exercise that are effective for the management of hand osteoarthritis and to provide stakeholders with updated, moderate to high-quality recommendations supporting exercises for hand osteoarthritis.

METHODS::

A systematic search and adapted selection criteria included comparable trials with exercise programmes for managing hand osteoarthritis. Based on the evaluated evidence, a panel of experts reached consensus through a Delphi approach endorsing the recommendations. A hierarchical alphabetical grading system (A, B, C+, C, C-, D-, D, D+, E, F) was based on clinical importance (≥15%) and statistical significance ( P < 0.05).

RESULTS::

Ten moderate- to high-quality studies were included. Eight studies with programmes involving therapeutic exercise (e.g. range of motion (ROM) + isotonic + isometric + functional exercise) seemed to be effective. Forty-six positive grade recommendations (i.e. A, B, C+) were obtained during short-term (<12 weeks) trials for pain, stiffness, physical function, grip strength, pinch strength, range of motion, global assessment, pressure pain threshold, fatigue and abductor pollicis longus moment and during long-term (>12 weeks) trials for physical function and pinch strength.

CONCLUSION::

Despite that many programmes involving exercise with positive recommendations for clinical outcomes are available to healthcare professionals and hand osteoarthritis patients that aid in the management of hand osteoarthritis, there is a need for further research to isolate the specific effect of exercise components.

KEYWORDS:

Therapeutic exercise; clinical practice guideline; hand osteoarthritis; rehabilitation; systematic review

PMID:
29911409
DOI:
10.1177/0269215518780973
[Indexed for MEDLINE]

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