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Table 1 Content of the combined-intervention delivered to participants according to the patient-centred standards of care for osteoarthritis [18]

From: Functional consultation and exercises improve grip strength in osteoarthritis of the hand – a randomised controlled trial

Flow chart combined intervention compared to RC group
All mentioned health professionals developed the intervention together. The combined intervention was delivered by an occupational therapist, physiotherapist, dietician and/or nurse according to their availability and the needs of the patient
Pain and difficulties with ADL assessment Patients have been asked in detail about the pain they experience and asked to report three activities of daily living that are difficult to perform for them
Information and functioning consultation The diagnosis made by the rheumatologist was explained to the patient in an easy and lay understandable format.
Information on an active and healthy lifestyle, physical activity, nutrition supplements, nutrition and if necessary (BMI > 27) information about the benefit of an optimal bodyweight was given
Possibilities of surgery were discussed briefly
Strategies for self-efficacy, ergonomic principles and pacing strategies were explained to maximise physical functioning
Pain management Information about medication, the resulting benefit and risks according to available guidelines was given. The value of thermotherapy was explained, especially the benefit of heat during stable periods and cold during inflamed periods. A hot and cold pack to apply hot and cold packing at home was provided free of charge for the patients
Assistive devices According to the difficulties in daily living reported by the patient, aids and devices were discussed and shown to the patient. Opening screw-caps is a commonly reported problem. If a patient mentioned having problems with this task a non-slip mat (Dycem) was provided and patients were trained in opening glasses/bottles with this device
All patients were assessed for the need of a CMC 1 joint orthosis (Additional file 1: Material 1 pictures of the CMC 1 orthosis). If required it was custom-made during the consultation
Hand exercises Patients in the combined-intervention group received instructions for a home-exercise programme to enhance range of motion and grip strength. Detailed information about the hand exercise programme is given in Fig. 1. The therapy putty necessary for the exercise programme was directly provided from the interdisciplinary team free of charge for the patient
Participants were instructed to exercise daily for 8 weeks with 10 repetitions during weeks 1–2, 12 repetitions in weeks 3–4 and 15 repetitions in weeks 5–8. Beside access to a web-based interactive online video showing the exercises for the hands, the programme was given in paper format to the participants. The programme is accessible following the link:
Follow up An appointment was scheduled for 8 weeks after the baseline intervention. Patients received a telephone number/email address to contact the therapist if they need further instructions after the consultation. After 1 month, patients received a follow-up telephone call from the therapist, who asked questions according to a standardised protocol, answered emerging questions and encouraged the patient to follow the advice given and the exercise regime
Patients were advised to bring the used therapy putty to the follow-up session in order to examine the exercise adherence of the individuals in the intervention group
  1. Patients received a booklet with general information, exercises, contact details from the health professionals and the link for the exercise video
  2. ADL activities of daily living, BMI body mass index, CMC carpometacarpal, OT occupational therapist, PT physiotherapist, RC routine care