Development of an evidence-based exercise programme for people with hand osteoarthritis

Background: Exercising is recommended for people with hand osteoarthritis (HOA), but there is no consensus regarding the design of exercise programmes. Objective: To describe the development and content of an evidence-based exercise programme for people with HOA. Methods: The development was based on research evidence, professional expertise, and client evidence and adhered to the new Medical Research Council framework for design and evaluation of complex interventions. The process included literature search and appraisal, discussions with clinicians and patient research partners, and piloting, followed by a revision of the programme based on feedback from pilot participants. Results: The programme contains three exercises to increase the strength and stability of the shoulder, arm and wrist muscles, and four exercises to maintain or increase range of motion, grip strength, and joint stability in the finger joints. It starts with a warm-up period, ends with a finger stretch exercise, and follows the American College of Sports Medicine's recommendations regarding exercise intensity, session frequency, and length of exercise period. An exercise diary is included as part of the programme. Conclusions: An evidence-based exercise programme for people with HOA has been developed. The effect of the programme has recently been evaluated in a randomized controlled trial.