Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review

Table 5 Summary of the higher-quality evidence for treating impairments and function in individuals with hand osteoarthritis

Treatment goals	Joints	Intervention	LOE	Quality: score on PEDro scale	Outcome tool	SMD (95% CI)
Pain reduction	CMC + IP	Splints: long-term night use (>12 months) [31]	1b	8	VAS	4.24 (3.52, 4.97)
Improve hand function	CMC + IP	Splints: Short-term night use (1 month) [31]	1b	8	CHFS	1.10 (0.68, 1.52)
		Splints: Long-term night use (>12 months) [31]				3.73 (3.05,4.40)
	CMC + IP	Joint protection education plus home exercise program [34]	2b	6	HAQ	NA, P < 0.05
Improve hand strength	CMC + IP	Splints: Short-term night use (1 month) [31]	1b	8	Pinch (Dy)	0.9 (0.5, 1.3)
		Splints: Long-term night use (>12 months) [31]				1.2 (0.8, 1.6)
	CMC + IP	Joint protection education plus home exercise program [34]	2b	6	Grip (V)	4.5 (3.3, 5.7)
Improve range of motion	CMC + IP	Splints: Long-term night use (>12 months) [31]	1b	8	KI	3.30 (2.7, 3.9)
	CMC	Low-level laser (20 minutes/session × 3 sessions/week) [24]	1b	10	G	NA, P = 0.011
Decrease stiffness	-	-	-	-	-	-

CHFS, Cochin hand functional scale; CI, confidence intervals for continuous variables; CMC, carpometacarpal; Dy, dynamometer(s); G, goniometer (s); HAQ, Health Assessment Questionnaire; IP, interphalangeal; KI, Kapandji index (thumb opposition); LOE, level of evidence (Oxford); NA, standardized mean difference not estimable; PEDro, Physiotherapy Evidence Database; SMD, standardized mean difference; V, vigorimeter VAS, visual analogue scale.

ISSN: 1478-6362