Recommendations for exercises in hand osteoarthritis: a systematic review protocol of clinical guidelines and consensus recommendations

Abstract

Background: Individuals with hand Osteoarthritis (OA) often experience pain, finger joint stiffness and reduced handgrip strength, which can affect daily functional task performance. There is a need to evaluate current and emerging evidence-based rehabilitation strategies that aim to lessen the burden and improve the quality of life of people living with the disease.

Objectives: This proposed systematic review aims to: (1) critically appraise all available published guidelines on hand OA to ascertain whether hand exercises are recommended as part of the current best practice for people with hand OA; (2) identify the type and dosage of exercises recommended regarding frequency, intensity and duration; (3) provide a summary of hand exercise recommendations for the management of hand OA.

Methods: This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis-Protocols (PRISMA-P) guidelines. A comprehensive search of seven published databases and 19 grey literature sources will be conducted from January 1997 to December 2017. All relevant guidelines will be critically appraised with the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument. Extracted hand exercise recommendations will be categorized and synthesized based on the levels of evidence and strength of recommendations using a narrative approach.

Conclusions: The proposed systematic review seeks to establish whether hand exercises are recommended as best practice for the management of hand OA. It will provide a comprehensive summary of recommendations on the type and dosage of hand exercises. This information will help develop future research questions on the clinical applicability of these exercises.

Keywords:

• Exercises
• guidelines
• hand osteoarthritis
• recommendations

Acknowledgements

The reviewers thank Paula Sands (PS) of the Health Services Library, University of Southampton for her immense support in searching the literature.

Ethics

This review did not require ethical approval since it is a review of already published papers.

Disclosure statement

Reviewers report no conflict of interest.

Additional information

Funding

The first reviewer, BS, is a Commonwealth Scholar, funded by the UK government to pursue doctoral studies.

Notes on contributors

Beatrice E. A. Sankah

Beatrice E. A. Sankah is PhD student at Faculty of Health Sciences (University of Southampton, UK). Maria Stokes is professor of Musculoskeletal Rehabilitation at Faculty of Health Sciences (University of Southampton, UK). Jo Adams is professor of Musculoskeletal Health at Faculty of Health Sciences (University of Southampton, UK).