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Hand Exercise Intervention in Patients with Polymyositis and Dermatomyositis: A Pilot Study

Authors

  • Malin Regardt,

    Corresponding author
    1. Department of Occupational Therapy, Karolinska University Hospital, Solna, Sweden
    2. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
    • Correspondence: Malin Regardt, Department of Occupational Therapy, Karolinska University Hospital, Solna, S-171 76 Stockholm, Sweden. Tel: +46 70 4095783; Fax: +46 8 517 730 80.

      Email: malin.regardt@karolinska.se

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  • Marie-Louise Schult,

    1. Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
    2. Rehabilitation Medicine University Clinic, Danderyd Hospital, Stockholm, Sweden
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  • Yvonne Axelsson,

    1. Department of Occupational Therapy, Karolinska University Hospital, Solna, Sweden
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  • Anna Aldehag,

    1. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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  • Helene Alexanderson,

    1. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
    2. Department of Physical Therapy, Karolinska University Hospital, Solna, Sweden
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  • Ingrid E. Lundberg,

    1. Rheumatology Unit, Karolinska University Hospital, Stockholm, Sweden
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  • Elisabet Welin Henriksson

    1. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
    2. Rheumatology Unit, Karolinska University Hospital, Stockholm, Sweden
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Abstract

Objective

The aim of the present study was to develop a 12-week hand exercise intervention for patients with polymyositis (PM) and dermatomyositis (DM) and evaluate adherence, patients' opinions of the programme design and overall feasibility, and the effect on hand function and activity limitation after the intervention.

Method

A pilot hand exercise intervention was conducted on a convenience sample of 15 patients with reduced handgrip strength and established, inactive PM and DM. Acceptable adherence was set at 75%. The programme was evaluated based on patients' opinions regarding exertion, the movements involved and overall feasibility. Hand- and pinch-grip strength, grip ability, dexterity and activity limitation were assessed.

Results

Eleven of 15 patients completed the intervention, with acceptable adherence of 78–100%. Measures of handgrip strength, dexterity and activity limitation were reduced at baseline compared with normative data from the literature. Throughout the intervention, rates of perceived exertion were scored between ‘moderate’ and ‘fairly strong’. Finger abduction and adduction were excluded from the hand exercise programme because they were not feasible to perform. Repetitions of the exercise increased gradually to a maximum of 30 per movement. Patients regarded this as too time-consuming and suggested ten repetitions daily or 10–20 repetitions 2–4 times per week. There were some individual, clinically meaningful improvements in hand function and activity limitation. A comparison between baseline and after the intervention showed that the three-jaw (tripod) pinch-grip strength (left hand) had increased (p < 0.007; z = –2.7).

Conclusion

A hand exercise programme was found to be feasible to perform by patients with established PM or DM. The effect was limited, with few individual improvements in hand function and activity limitation, indicating a need to increase the resistance in the movements and to limit the duration of each exercise session. Copyright © 2014 John Wiley & Sons, Ltd.

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