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<div class="editorbox"> '''Original Editor '''- [[User:User Name|Shaimaa Eldib]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
<div class="editorbox">'''Original Editor '''- [[User:Shaimaa Eldib|Shaimaa Eldib]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
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== Introduction: ==
== Introduction ==
Hand Exercises are used as an intervention that aims to improve the mobility and strength of the hand and therefore,improving functional ability. Hand exercise may include:
[[File:Weighted finger curls.jpg|thumb]]
[[File:Digit ROM Exercise Handout.jpg|thumb]]
Hand exercises are a beneficial intervention for improving hand mobility, strength, and functional ability.  
* Mobilizing exercise (Increase or maintain range of motion)       
* Strengthing exercise ( that use resistance from putty, a gel ball, or elastic band to strengthen hand and wrist muscles)<ref name=":0">Williams MA, Srikesavan C, Heine PJ, Bruce J, Brosseau L, Hoxey‐Thomas N, Lamb SE. Exercise for rheumatoid arthritis of the hand. Cochrane Database of Systematic Reviews. 2018(7).</ref>


There are many conditions that may affect the hand and need exercise as an intervention to help patients to perform their ADL activities independently and increase the strength of handgrip. <ref>Ellegaard K, von Bülow C, Røpke A, Bartholdy C, Hansen IS, Rifbjerg-Madsen S, Henriksen M, Wæhrens EE. Hand exercise for women with rheumatoid arthritis and decreased hand function: an exploratory randomized controlled trial. Arthritis research & therapy. 2019 Dec 1;21(1):158.</ref> 
They may include:  
* '''Example of conditions:'''
* '''Mobilizing exercises''' to increase or maintain range of motion.
'''[[Osteoarthritis]]''' is the most common joint disease and most frequently affects [[Hand Function|the hand]].<ref>Fife RS, Klippel J. Primer on the rheumatic diseases.</ref> This disease leads to pain in and around the affected [[Joint Classification|joints]] and to swelling, stiffness, deformity, and gradual loss of function. As a result, the ability to perform daily tasks may become impaired or lost.<ref>Stamm TA, Machold KP, Smolen JS, Fischer S, Redlich K, Graninger W, Ebner W, Erlacher L. Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: a randomized controlled trial. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2002 Feb;47(1):44-9.</ref> A randomized controlled trail conducted in 2015  found that hand exercises were well tolerated and significantly improved activity performance, grip strength, pain and fatigue in women with HOA<ref>Hennig T, Hæhre L, Hornburg VT, Mowinckel P, Norli ES, Kjeken I. Effect of home-based hand exercises in women with hand osteoarthritis: a randomised controlled trial. Annals of the rheumatic diseases. 2015 Aug 1;74(8):1501-8.</ref>.
* '''Strengthening exercises''' using resistance from putty, a gel ball, or elastic bands.
* '''Stretching exercises''' to increase muscle flexibility of the fingers and wrist.


'''[[Rheumatoid Arthritis|Rheumatoid arthritis]]''' is the most common polyarthritis and affecting 1% of the population. Most of RA patients suffer from frequent problems for the hand and wrist like inflammation, [[Swan-neck deformity|deformity (swan neck deformity)]], pain, weakness, and restricted mobility, resulting in loss of function<ref name=":0" /><ref>Lamb SE, Williamson EM, Heine PJ, Adams J, Dosanjh S, Dritsaki M, Glover MJ, Lord J, McConkey C, Nichols V, Rahman A. Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial. The Lancet. 2015 Jan 31;385(9966):421-9.</ref>.       
Many conditions may affect the hand and need exercise as an intervention to help patients to perform their ADL activities independently and increase the strength of the handgrip. <ref>Ellegaard K, von Bülow C, Røpke A, Bartholdy C, Hansen IS, Rifbjerg-Madsen S, Henriksen M, Wæhrens EE. Hand exercise for women with rheumatoid arthritis and decreased hand function: an exploratory randomized controlled trial. Arthritis research & therapy. 2019 Dec 1;21(1):158.</ref>


=== Hand exercise ===
=== Common Conditions Affecting Hand ===
Osteoarthritis and rheumatoid arthritis are two common conditions that affect the hand and require exercise as an intervention to help patients perform daily activities independently and increase hand strength.
 
'''[[Osteoarthritis]]''' is the most common joint disease and frequently affects the [[Hand Function|hand]], leading to pain, swelling, stiffness, deformity, and gradual loss of function.<ref>Fife RS, Klippel J. Primer on the rheumatic diseases.</ref> <ref>Stamm TA, Machold KP, Smolen JS, Fischer S, Redlich K, Graninger W, Ebner W, Erlacher L. Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: a randomized controlled trial. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2002 Feb;47(1):44-9.</ref>A study found that hand exercises were well-tolerated and significantly improved activity performance, grip strength, pain, and fatigue in women with osteoarthritis.<ref>Hennig T, Hæhre L, Hornburg VT, Mowinckel P, Norli ES, Kjeken I. Effect of home-based hand exercises in women with hand osteoarthritis: a randomized controlled trial. Annals of the rheumatic diseases. 2015 Aug 1;74(8):1501-8.</ref>.
 
'''[[Rheumatoid Arthritis|Rheumatoid arthritis]]''' is the most common polyarthritis and affecting '''0.24 to 1%''' of the population. RA patients often experience hand and wrist problems like inflammation, deformity, pain, weakness, and restricted mobility, resulting in loss of function. Hand exercises can help strengthen muscles and tendons in the hand and forearms, improve range of motion in the fingers and thumbs, and enhance hand function.<ref name=":0">Williams MA, Srikesavan C, Heine PJ, Bruce J, Brosseau L, Hoxey‐Thomas N, Lamb SE. Exercise for rheumatoid arthritis of the hand. Cochrane Database of Systematic Reviews. 2018(7).</ref><ref>Lamb SE, Williamson EM, Heine PJ, Adams J, Dosanjh S, Dritsaki M, Glover MJ, Lord J, McConkey C, Nichols V, Rahman A. Exercises to improve the function of the rheumatoid hand (SARAH): a randomized controlled trial. The Lancet. 2015 Jan 31;385(9966):421-9.</ref>       
 
=== Hand exercises ===
Here is an example of hand exercises for hand related conditions:
 
The exercises include:
* Finger and Thumb Stretches: Gently stretch the fingers and thumbs by holding them in a straight position for a few seconds, then bending them down and holding them for a few seconds. Repeat 10 times.
* Finger and Thumb Touches: Touch the tip of each finger to the tip of the thumb, one at a time, and hold for a few seconds. Repeat 10 times.
* Finger and Thumb Lifts: Place your hand flat on a table and lift each finger and thumb off the table one at a time, holding for a few seconds. Repeat 10 times.
* Finger and Thumb Squeezes: Squeeze a softball or putty with your fingers and thumb, holding for a few seconds. Repeat 10 times.
* Wrist Flexion and Extension: Hold your arm out in front of you with your palm facing down. Bend your wrist up and down, holding for a few seconds. Repeat 10 times.
* Wrist Circles: Hold your arm out in front of you with your palm facing down. Make circles with your wrist, holding for a few seconds. Repeat 10 times.
 
These exercises can help improve hand mobility, strength, and flexibility, and are beneficial for individuals with rheumatoid arthritis or those looking to maintain hand function and independence.


{{#ev:youtube|GyCdT6hTgeA}}
{{#ev:youtube|GyCdT6hTgeA}}


=== '''iSARAH Hand Exercise''' ===
=== iSARAH Hand Exercises ===
The iSARAH program is a tailored hand exercise program designed to help patients with rheumatoid arthritis (RA) improve hand strength and flexibility. <ref name=":1">Hall AM, Copsey B, Williams M, Srikesavan C, Lamb SE, Sarah Trial Team. The mediating effect of changes in hand impairments on hand function in patients with rheumatoid arthritis: exploring the mechanisms of an effective exercise program. Arthritis care & research. 2017 Jul;69(7):982-8.</ref>
 
A multi-trial conducted in the UK involving '''490 adult RA patients'' concluded that the iSARAH program is a worthwhile, low-cost intervention to provide as an adjunct to various drug regimens.<ref>Lamb SE, Williamson EM, Heine PJ, Adams J, Dosanjh S, Dritsaki M, Glover MJ, Lord J, McConkey C, Nichols V, Rahman A. Exercises to improve the function of the rheumatoid hand (SARAH): a randomized controlled trial. The Lancet. 2015 Jan 31;385(9966):421-9.</ref> <ref>Williams MA, Williamson EM, Heine PJ, Nichols V, Glover MJ, Dritsaki M, Adams J, Dosanjh S, Underwood M, Rahman A, McConkey C. Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH). A randomized controlled trial and economic evaluation.</ref>{{#ev:youtube|q1pNhMkJHhg}}<ref>[[https://www.rheumatology.org.uk/guidelines|Guidelines | British Society for Rheumatology]]</ref>
 
The program includes '''11 flexibility and strength exercises''' and behavioral change support strategies recommended by health professionals to help patients adhere to their exercise regimen and make hand exercising a daily habit.
 
A qualitative longitudinal study found that establishing a routine was an important step toward participants being able to exercise independently, and therapists provided participants with the skills to continue exercising while dealing with changes in symptoms and schedules. <ref name=":2">Nichols VP, Williamson E, Toye F, Lamb SE. A longitudinal, qualitative study exploring sustained adherence to a hand exercise program for rheumatoid arthritis evaluated in the SARAH trial. Disability and rehabilitation. 2017 Aug 28;39(18):1856-63.</ref>Healthcare professionals can take the course for the iSARAH hand program to implement this evidence-based hand exercise program into their practice effectively.
 
For more information on the iSARAH program, healthcare professionals can visit the following link: [https://isarah.octru.ox.ac.uk/course/index.php iSARAH Hand Program].


== References ==
== References ==
[[Category:Hand - Interventions]]
[[Category:Hand - Interventions]]
<references />
<references />

Latest revision as of 16:52, 11 January 2024

Original Editor - Shaimaa Eldib Top Contributors - Shaimaa Eldib, Mohit Chand, Kim Jackson, Seba Mamdouh and Vidya Acharya

Introduction[edit | edit source]

Weighted finger curls.jpg

Hand exercises are a beneficial intervention for improving hand mobility, strength, and functional ability.

They may include:

  • Mobilizing exercises to increase or maintain range of motion.
  • Strengthening exercises using resistance from putty, a gel ball, or elastic bands.
  • Stretching exercises to increase muscle flexibility of the fingers and wrist.

Many conditions may affect the hand and need exercise as an intervention to help patients to perform their ADL activities independently and increase the strength of the handgrip. [1]

Common Conditions Affecting Hand[edit | edit source]

Osteoarthritis and rheumatoid arthritis are two common conditions that affect the hand and require exercise as an intervention to help patients perform daily activities independently and increase hand strength.

Osteoarthritis is the most common joint disease and frequently affects the hand, leading to pain, swelling, stiffness, deformity, and gradual loss of function.[2] [3]A study found that hand exercises were well-tolerated and significantly improved activity performance, grip strength, pain, and fatigue in women with osteoarthritis.[4].

Rheumatoid arthritis is the most common polyarthritis and affecting 0.24 to 1% of the population. RA patients often experience hand and wrist problems like inflammation, deformity, pain, weakness, and restricted mobility, resulting in loss of function. Hand exercises can help strengthen muscles and tendons in the hand and forearms, improve range of motion in the fingers and thumbs, and enhance hand function.[5][6]

Hand exercises[edit | edit source]

Here is an example of hand exercises for hand related conditions:

The exercises include:

  • Finger and Thumb Stretches: Gently stretch the fingers and thumbs by holding them in a straight position for a few seconds, then bending them down and holding them for a few seconds. Repeat 10 times.
  • Finger and Thumb Touches: Touch the tip of each finger to the tip of the thumb, one at a time, and hold for a few seconds. Repeat 10 times.
  • Finger and Thumb Lifts: Place your hand flat on a table and lift each finger and thumb off the table one at a time, holding for a few seconds. Repeat 10 times.
  • Finger and Thumb Squeezes: Squeeze a softball or putty with your fingers and thumb, holding for a few seconds. Repeat 10 times.
  • Wrist Flexion and Extension: Hold your arm out in front of you with your palm facing down. Bend your wrist up and down, holding for a few seconds. Repeat 10 times.
  • Wrist Circles: Hold your arm out in front of you with your palm facing down. Make circles with your wrist, holding for a few seconds. Repeat 10 times.

These exercises can help improve hand mobility, strength, and flexibility, and are beneficial for individuals with rheumatoid arthritis or those looking to maintain hand function and independence.

iSARAH Hand Exercises[edit | edit source]

The iSARAH program is a tailored hand exercise program designed to help patients with rheumatoid arthritis (RA) improve hand strength and flexibility. [7]

A multi-trial conducted in the UK involving '490 adult RA patients concluded that the iSARAH program is a worthwhile, low-cost intervention to provide as an adjunct to various drug regimens.[8] [9]

[10]

The program includes 11 flexibility and strength exercises and behavioral change support strategies recommended by health professionals to help patients adhere to their exercise regimen and make hand exercising a daily habit.

A qualitative longitudinal study found that establishing a routine was an important step toward participants being able to exercise independently, and therapists provided participants with the skills to continue exercising while dealing with changes in symptoms and schedules. [11]Healthcare professionals can take the course for the iSARAH hand program to implement this evidence-based hand exercise program into their practice effectively.

For more information on the iSARAH program, healthcare professionals can visit the following link: iSARAH Hand Program.

References[edit | edit source]

  1. ↑ Ellegaard K, von Bülow C, Røpke A, Bartholdy C, Hansen IS, Rifbjerg-Madsen S, Henriksen M, Wæhrens EE. Hand exercise for women with rheumatoid arthritis and decreased hand function: an exploratory randomized controlled trial. Arthritis research & therapy. 2019 Dec 1;21(1):158.
  2. ↑ Fife RS, Klippel J. Primer on the rheumatic diseases.
  3. ↑ Stamm TA, Machold KP, Smolen JS, Fischer S, Redlich K, Graninger W, Ebner W, Erlacher L. Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: a randomized controlled trial. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2002 Feb;47(1):44-9.
  4. ↑ Hennig T, Hæhre L, Hornburg VT, Mowinckel P, Norli ES, Kjeken I. Effect of home-based hand exercises in women with hand osteoarthritis: a randomized controlled trial. Annals of the rheumatic diseases. 2015 Aug 1;74(8):1501-8.
  5. ↑ Williams MA, Srikesavan C, Heine PJ, Bruce J, Brosseau L, Hoxey‐Thomas N, Lamb SE. Exercise for rheumatoid arthritis of the hand. Cochrane Database of Systematic Reviews. 2018(7).
  6. ↑ Lamb SE, Williamson EM, Heine PJ, Adams J, Dosanjh S, Dritsaki M, Glover MJ, Lord J, McConkey C, Nichols V, Rahman A. Exercises to improve the function of the rheumatoid hand (SARAH): a randomized controlled trial. The Lancet. 2015 Jan 31;385(9966):421-9.
  7. ↑ Hall AM, Copsey B, Williams M, Srikesavan C, Lamb SE, Sarah Trial Team. The mediating effect of changes in hand impairments on hand function in patients with rheumatoid arthritis: exploring the mechanisms of an effective exercise program. Arthritis care & research. 2017 Jul;69(7):982-8.
  8. ↑ Lamb SE, Williamson EM, Heine PJ, Adams J, Dosanjh S, Dritsaki M, Glover MJ, Lord J, McConkey C, Nichols V, Rahman A. Exercises to improve the function of the rheumatoid hand (SARAH): a randomized controlled trial. The Lancet. 2015 Jan 31;385(9966):421-9.
  9. ↑ Williams MA, Williamson EM, Heine PJ, Nichols V, Glover MJ, Dritsaki M, Adams J, Dosanjh S, Underwood M, Rahman A, McConkey C. Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH). A randomized controlled trial and economic evaluation.
  10. ↑ [| British Society for Rheumatology]
  11. ↑ Nichols VP, Williamson E, Toye F, Lamb SE. A longitudinal, qualitative study exploring sustained adherence to a hand exercise program for rheumatoid arthritis evaluated in the SARAH trial. Disability and rehabilitation. 2017 Aug 28;39(18):1856-63.
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