RODRIGUEZ SANCHEZ-LAULHE, PABLO, Biscarri-Carbonero, Angela , Suero-Pineda, Alejandro , Luque-Romero, Luis G. , Garcia, Francisco J. Barrero , Blanquero, Jesus , Heredia-Rizo, Alberto M.
No
Eur. J. Phys. Rehabil. Med.
Article
Científica
3.3
0.955
01/02/2023
000975396800007
BACKGROUND: Exercise therapy, self-management and education are recommended interventions for hand osteoarthritis (OA), but new de-livery systems are needed to solve lack of adherence.AIM: To determine the effects on hand function and pain related measures of a mobile app-delivered intervention, compared with usual care, in patients with symptomatic hand OA.DESIGN: A pragmatic, multicenter, two-group parallel randomized controlled trial.SETTING: Community health centers in rural southern Spain.POPULATION: Eighty-three participants with unilateral or bilateral symptomatic hand OA were proposed to participate, and finally 74 were included and randomized.METHODS: Participants received a home multimodal treatment (exercise, education, and self-management recommendations) with the Care -Hand mobile app or usual care (written exercises) over 12 weeks. Monthly telephone calls were performed to monitor adherence. The primary outcome was hand physical function (Australian/Canadian Hand Osteoarthritis Index, AUSCAN) at 3-and 6-months. Secondary measures included hand pain intensity and morning stiffness, upper limb function, hand dexterity, and grip and pinch strength.RESULTS: The CareHand group showed significant within-group changes in hand function at 6-months (-3.0, 95% CI-5.1 to-0.9 vs. usual care:-0.9, 95% CI-3.3 to 1.5). Neither group showed improvements in hand function at 3-months (CareHand:-1.5, 95% CI-3.1 to 0.1; usual care:-0.5, 95% CI-2.7 to 1.7). For the secondary outcomes, the CareHand group showed better results on upper limb function both at 3-and 6-months, and on pain both at 1-and 3-months compared to usual care group. Linear regression models indicated that baseline scores of pain intensity, hand status, and upper limb function were associated with a greater improvement in hand pain and physical function.CONCLUSIONS: A mobile app-delivered intervention is effective for improving hand function, and better than usual care for upper limb func-tion and pain. Further research is warranted to understand the impact of mobile health (mHealth) in people with hand OA. CLINICAL REHABILITATION IMPACT: mHealth interventions are a feasible and secure multimodal delivery approach in older adults with hand OA in rural primary care setting. Baseline pain and upper limb function might predict functional hand outcomes.
wo?ns; Exercise therapy; Hand; Telemedicine; Osteoarthritis; Self-management