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Table 2 Summary of findings: resistance training compared with no exercise for hand osteoarthritis

From: The effects of resistance training on muscle strength, joint pain, and hand function in individuals with hand osteoarthritis: a systematic review and meta-analysis

Outcomes

Anticipated absolute effects* (95% CI)

Number of participants (studies)

Quality of evidence (GRADE)

Comments

Risk with no exercise

Risk with resistance training

Grip strength (at study completion)

assessed with: hand dynamometer.

Follow-up: range 6–24 weeks

Mean grip strength (at study completion) in the control group was 17.7 kg

Mean grip strength (at study completion) in the intervention group was 1.35 kg higher (0.84 lower to 3.54 higher)

350 (5 RCTs)

⨁⨁⨁◯ moderatea

MD 1.35 kg (95% CI = –0.84, 3.54). Relative increase 8% with resistance exercise (95% CI = –5% weaker, 20% stronger). MCID for grip strength is 20%b

Hand pain (at study completion)

assessed with: AUSCAN pain, 11-point NRS, Likert scale.

Lower scores mean less pain.

Follow-up: range 6–16 weeks

Pain score in the resistance training groups was on average –0.23 SDs (–0.42 lower to –0.04 lower) lower than in the control groups.e

379 (5 RCTs)

⨁⨁◯◯ lowa,c

These results can be interpreted as an improvement of 0.46 (95% CI = 0.08, 0.84) points on a 11-point NRS scale.d MCID for pain is 2 points [39]

Hand function (at study completion)

assessed with: AUSCAN function, FIHOA.

Lower scores mean better function.

Follow-up: range 6–16 weeks

The function score in the resistance training groups was on average –0.10 SDs (–0.33 lower to 0.13 higher) lower than in the control groups.

363 (4 RCTs)

⨁⨁◯◯ lowa,c

As a rule of thumb, 0.2 SDs represents a small difference, 0.5 a moderate difference, and 0.8 a large difference

  1. Patient or population: hand osteoarthritis
  2. Setting: general practice, community, retirement villages
  3. Intervention: resistance training
  4. Comparison: no exercise
  5. CI confidence interval, AUSCAN Australian Canadian Osteoarthritis Hand Index, NRS Numerical Rating Scale, FIHOA Functional Index of Hand Osteoarthritis, RCT randomised controlled trial, MD mean difference, SD standard deviation, MCID minimal clinically important difference, GRADE Grade of Recommendations Assessment, Development, and Evaluation
  6. * Risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
  7. GRADE Working Group grades of evidence
  8. High quality : We are very confident that the true effect lies close to that of the estimate of the effect
  9. Moderate quality: We are moderately confident in the effect estimate (the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different)
  10. Low quality: Our confidence in the effect estimate is limited (the true effect may be substantially different from the estimate of the effect)
  11. Very low quality: We have very little confidence in the effect estimate (the true effect is likely to be substantially different from the estimate of effect)
  12. a Downgraded because few participants (imprecision)
  13. b MCID for grip strength in people following a radial fracture [47]
  14. c Downgraded because participants were not blinded to intervention (risk of bias)
  15. d The control group pain mean (SD) 4.6 (2) was calculated by averaging the 11-point NRS scores of Dziedzic et al. [27], Hennig et al. [31], and Østerås et al. [29]e This result was statistically significant (p = 0.02)
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Arthritis Research & Therapy

ISSN: 1478-6362

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