Early therapy improves hand strength in RA patients

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Occupational therapy that focuses on the hand and wrist may be helpful for people in the early stages of rheumatoid arthritis, the results of a small study suggest.

As rheumatoid arthritis (RA) progresses, problems with hand function often become an obstacle in daily life. On average, RA patients’ hand-grip strength is about 75 percent lower than that of healthy adults—making routine tasks like opening a jar or lifting a grocery bag challenging.

For the new study, French researchers looked at whether occupational therapy for the hand and wrist could be useful for people recently diagnosed with RA.

Occupational therapy aims to help people with various diseases or disabilities maintain their ability to perform everyday tasks. In this study, therapists taught patients how to protect their joints during daily activities and gave them hand and wrist exercises to perform each day on their own. The patients also wore splints at night to stabilize and protect the joints. 

The 60 RA patients were divided into two groups: one that received occupational therapy right away, and one that started the therapy 3 months later.

After the first 3 months, patients who’d received occupational therapy showed a gain in grip strength compared with the other group.

Once patients in the latter group began therapy, they showed strength improvements similar to those in the first group, the researchers report in the Annals of the Rheumatic Diseases.

“The key point of the study is that (occupational therapy) leads to increased hand strength,” senior researcher Dr. Pierre Miossec, of Hopital Edouard-Herriot in Lyon, told Reuters Health. “It indicates that patients with RA should remain active.”

This is contrast, he added, to the traditional idea that RA patients should take it easy. “It is just the opposite,” Miossec said. The results also support starting occupational therapy sooner rather than later.

SOURCE: Annals of Rheumatic Diseases, March 2009.

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