Exercise programme with telephone follow-up for people with hand osteoarthritis - protocol for a randomised controlled trial

• Published in: BMC musculoskeletal disorders 2014-03, Vol.15 (1), p.82-82, Article 82
• Main Authors: Østerås, Nina, Hagen, Kåre Birger, Grotle, Margreth, Sand-Svartrud, Anne-Lene, Mowinckel, Petter, Aas, Eline, Kjeken, Ingvild
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analysis; Care and treatment; Clinical Protocols; Cost benefit analysis; Education, Continuing; Exercise; Exercise Therapy - economics; Female; Follow-Up Studies; Hand Joints - physiopathology; Hand Strength; Humans; Male; Medical treatment; Middle Aged; Occupational Therapy - education; Older people; Osteoarthritis - economics; Osteoarthritis - therapy; Pain; Physical Therapists - education; Single-Blind Method; Studies; Study Protocol; Telephone; Therapists
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/1471-2474-15-82

Hand osteoarthritis (OA) is one of the most prevalent musculoskeletal diseases in an adult population and may have a large influence on an individual's functioning, health-related quality of life and participation in society. Several studies have demonstrated that exercises may reduce pain and improve functioning in people with knee OA, with a similar effect suggested for hip OA. For hand OA, available research is very limited and shows conflicting results, and high-quality randomised controlled trials are warranted.This paper outlines the protocol for a randomised controlled trial that aims to determine the effect of an exercise intervention on self-reported hand activity performance in people with hand OA. Participants with physician-confirmed hand OA according to the ACR clinical criteria are being recruited from two Norwegian OA cohorts: the population-based "Musculoskeletal pain in Ullensaker Study" (MUST) OA cohort, and the hospital-based Oslo Hand OA cohort. Participants are randomised into an intervention- or control group. The control group receives "usual care", whereas the intervention group receives a 12-week exercise intervention. The intervention group attends four group sessions and is instructed to perform the exercise program three times a week at home. Adherence will be captured using self-report. During the eight weeks with no group sessions, the intervention group receives a weekly telephone call. The assessments and group sessions are being conducted locally in Ullensaker Municipality and at Diakonhjemmet Hospital, Oslo. Outcomes are collected at baseline, and at 3 and 6 months. The primary outcome measure is self-reported hand activity performance at 3 months post-randomisation, as measured by the Functional Index for Hand Osteoarthritis (FIHOA); and a patient-generated measure of disability, the Patient-Specific Functional Scale (PSFS). Secondary outcome measures are self-reported OA symptoms (e.g. pain, stiffness and fatigue), the Patient Global Assessment of disease activity, measured hand function (e.g. grip strength, thumb web space and hand dexterity) and health-related quality of life. Cost-utility and cost-effectiveness analyses will be conducted. This study will contribute to the knowledge on both the effect and resource use of an exercise programme with telephone follow-up on self-reported hand activity performance among people with hand OA. The trial is registered at ClinicalTrials.gov with registration number: NCT01245842.