Effectiveness of a fine motor skills rehabilitation program on upper limb disability, manual dexterity, pinch strength, range of fingers motion, performance in activities of daily living, functional independency, and general self-efficacy in hand osteoarthritis: A randomized clinical trial

Study Design: A randomized clinical trial. Introduction: Rehabilitation treatments for improving fine motor skills (FMS) in hand osteoarthritis (HOA) have not been well explored yet. Purpose of the Study: To assess the effectiveness of a rehabilitation program on upper limb disability, independence of activities of daily living (ADLs), fine motor abilities, functional independency, and general self-efficacy in older adults with HOA. Methods: About 45 adults (74-86 years) with HOA were assigned to an experimental group for completing an FMS intervention or a control group receiving conventional occupational therapy. Both interventions were performed 3 times/wk, 45 minutes each session, during 8 weeks. Upper limb disability, performance in ADLs, pinch strength, manual dexterity, range of fingers motion, functional independency, and general self-efficacy were assessed at baseline, immediately after treatment, and after 2 months of follow-up. Results: FMS group showed significant improvements with a small effect size on manual dexterity (P <=.034; d >= 0.48) and a moderate-high effect on range of index (P <.018; d >= 0.58) and thumb (P <=.027; d >= 0.39) motion. The control group showed a significant worse range of motion over time in some joints at the index (P <=.037; d >= 0.36) finger and thumb (P <=.017; d >= 0.55). Conclusions: A rehabilitation intervention for FMS may improve manual dexterity and range of fingers motion in HOA, but its effects on upper limb disability, performance in ADLs, pinch strength, functionality, and self-efficacy remain uncertain. Specific interventions of the hand are needed to prevent a worsening in range of finger motion. (C) 2016 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.