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by Dr. C.H. Weaver M.D. 11/2019

Fortunately for people affected by rheumatoid arthritis (RA) in their hands, medication can help control disease activity and joint damage. Additional therapies are needed, however, to help these patients maintain function of their hands and preserve quality of life. According to findings recently published in The Lancet, specific hand exercises may benefit these patients and are an affordable, safe alternative to expensive drugs.

Researchers in the UK conducted a large, multi-center study to measure the effectiveness and cost of a hand exercise regimen for people with RA. The 490 patients who participated had been on regular medication for RA for at least three months before the start of the trial.

They were divided into two groups for the study: one continued with medication, and the other continued with medication and added a routine of hand stretching and strengthening exercises (which were supervised by physical or occupational therapists). Both groups maintained their regular care during the study.

At a 12-month follow-up, researchers used a hand-specific outcomes instrument, the Michigan Hand Outcomes Questionnaire (MHQ), to measure overall hand function. The patients who did hand exercises in addition to taking medication had significantly improved overall hand function compared with the medication-only group.

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The exercise group had an improvement of 7.9 points on the MHQ compared with a 3.6-point improvement in the medication-only group (a more than doubled improvement). There were no serious adverse events associated with the exercise program. And at about $250 per patient, the exercise program was considered affordable.

Based on these findings, hand exercises in addition to appropriate medication appear to be an effective, safe, and affordable therapy for patients whose hands are affected by RA. This intervention could have a positive impact on quality of life for people living with RA.

Reference: Lamb SE, Williamson EM, Heine PJ, et al. Exercises to Improve Function of the Rheumatoid Hand (SARAH): a Randomised Controlled Trial. The Lancet [early online publication]. October 10, 2014.