Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand osteoarthritis

Scand J Occup Ther. 2011 Dec;18(4):265-81. doi: 10.3109/11038128.2010.514942. Epub 2010 Nov 22.


Aims: The aims of this study were to develop recommendations for occupational therapy assessment and design of hand exercise programmes in patients with hand osteoarthritis.

Methods: An expert group followed a Delphi procedure to reach consensus for up to 10 recommendations for assessment and exercises, respectively. Thereafter, an evidence-based approach was used to identify and appraise research evidence supporting each recommendation, before the recommendations were validated by the expert group.

Results: The process resulted in 10 recommendations for assessment and eight for design of exercise programmes. The literature search revealed that there is a paucity of clinical trials to guide recommendations for hand osteoarthritis, and the evidence for the majority of the recommendations was based on expert opinions. Also, even if a systematic review demonstrates some evidence for the efficacy of strength training exercises in hand OA, the evidence for any specific exercise is limited to expert opinions.

Conclusions: A first set of recommendations for assessment and exercise in hand osteoarthritis has been developed. For many of the recommendations there is a paucity of research evidence. High-quality studies are therefore needed to establish a high level of evidence concerning functional assessment and the effect of hand exercises in hand osteoarthritis.

MeSH terms

  • Adult
  • Delphi Technique
  • Disability Evaluation*
  • Evidence-Based Medicine*
  • Exercise Therapy*
  • Female
  • Hand
  • Hand Strength
  • Humans
  • Middle Aged
  • Occupational Therapy
  • Osteoarthritis / diagnosis
  • Osteoarthritis / rehabilitation*
  • Pain / rehabilitation
  • Range of Motion, Articular