None listed
Conditions
Brief summary
Rationale. Hand osteoarthritis (OA) is a painful degenerative condition, which often leads to muscle performance impairments and disability in older people. Despite its social and economic burden on the health care system, limited interventions are available. Conservative interventions such as high intensity strength training have been successfully trialled and utilised in people with knee and hip OA. In people with hand OA however, high intensity training is not always possible due to pain exacerbations. An alternative form of low load strength training called blood flow restriction training (BFR) has been shown to be effective and more acceptable than traditional high intensity strength training in people with knee OA. It is the aim of this study to explore the effectiveness of BFR in people with hand OA and compare its acceptability to a traditional high intensity strength training. Methods. A randomised controlled trial will assess the differences across three groups, which will undergo blood flow restriction training exercise, traditional high intensity exercise or a control group undergoing no exercise. Each group will include 22 participants for a total of 66 participants. The intervention will last 6 weeks and outcome measures, which include grip strength, joint pain and hand function, will be measured immediately before starting the intervention and one week after trial completion. Repeated measures Analysis of Variance, Pearson’s correlation, t-test and chi square tests will be utilised to analyse the data collected. Expected Outcomes. The present study may improve participants grip strength, joint pain and hand function. Furthermore, clinicians may be provided with additional treatments to improve patients function and quality of life. Finally, if BFR is effective, its use for additional rehabilitation studies may be justified.
Interventions
Arm 1: Blood flow restriction exercise.
Training period: 6 weeks.
Training frequency: 3 days per week.
Exercise mode: Thumb abductors/extensors, interosseous, pinching, gripping muscle exercises.
Training intensity: 30% to 40% of maximum voluntarily contraction.
A physiotherapist will prescribe the exercises. Blood flow restriction will be applied using a pneumatic cuff with a handheld sphygmomanometer. The cuff will be applied to the arm, proximally to the muscles exercised. The cuff will provi
Arm 1: Blood flow restriction exercise. Training period: 6 weeks. Training frequency: 3 days per week. Exercise mode: Thumb abductors/extensors, interosseous, pinching, gripping muscle exercises. Training intensity: 30% to 40% of maximum voluntarily contraction. A physiotherapist will prescribe the exercises. Blood flow restriction will be applied using a pneumatic cuff with a handheld sphygmomanometer. The cuff will be applied to the arm, proximally to the muscles exercised. The cuff will provide an individualised restriction of the blood flow, but will not cause arterial occlusion. Participants will be individually supervised throughout the training session by a physiotherapist, ensuring adherence and safety. Each exercise session will last approximately 30 minutes. The blood flow restriction exercise group will receive education about disease through a brochure provided after group randomisation. Arm 2: Traditional high intensity exercise. Training period: 6 weeks. Training frequency: 3 days per week. Exercise mode: Thumb abductors/extensors, interosseous, pinching, gripping muscle exercises. Training intensity: 60% to 70% of maximum voluntarily contraction. The same physiotherapist as for arm 1 will prescribe the exercises. The traditional high intensity group will undertake exercise without blood flow restriction, and without application of a blood flow restriction cuff. Each exercise session will last approximately 30 minutes. The traditional high intensity exercise group will receive education about disease through a brochure provided after group randomisation.
Sponsors
Nicoló Edoardo Magni
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Symptomatic and radiographic hand osteoarthritis.
Exclusion criteria
Participated in strength training in the last six months. Uncontrolled cardiovascular disease such as high blood pressure, history of rhabdomyolysis, conditions affecting blood clotting, and neurological diseases.
Outcome results
None listed