The effectiveness of joint-protection programs on pain, hand function, and grip strength levels in patients with hand arthritis: A systematic review and meta-analysis
Abstract
Study design Systematic review with meta-analysis.Introduction Joint protection (JP) has been developed as a self-management intervention to assist people with hand arthritis to improve occupational performance and minimize joint deterioration over time.Purpose of the study We examined the effectiveness between JP and usual care/control on pain, hand function, and grip strength levels for people with hand osteoarthritis and rheumatoid arthritis.Methods A search was performed in 5 databases from January 1990 to February 2017. Two independent assessors applied Cochrane's risk of bias tool, and a Grading of Recommendations Assessement, Development and Evaluation (GRADE) approach was adopted.Results For pain levels at short term, we found similar effects between JP and control standardized mean difference (SMD; -0.00, 95% confidence interval [CI]: -0.42 to 0.42, I 2 = 49%), and at midterm and long-term follow-up, JP was favored over usual care SMD (-0.32, 95% CI: -0.53 to -0.11, I 2 = 0) and SMD (-0.27, 95% CI: -0.41 to -0.12, I 2 = 9%), respectively. For function levels at midterm and long-term follow-up, JP was favored over usual care SMD (-0.49, 95% CI: -0.75 to -0.22, I 2 = 34%) and SMD (-0.31, 95% CI: -0.50 to -0.11, I 2 = 56%), respectively. For grip strength levels, at long term, JP was inferior over usual care mean difference (0.93, 95% CI: -0.74 to 2.61, I 2 = 0%).Conclusions Evidence of very low to low quality indicates that the effects of JP programs compared with usual care/control on pain and hand function are too small to be clinically important at short-, intermediate-, and long-term follow-ups for people with hand arthritis.
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Interventions such as joint protection, exercise therapy, mobilization, and modalities in hand therapy have well-established benefits for pain and function.
“Interventions such as joint protection [16], exercise therapy [17], mobilization [18], and modalities [19] in hand therapy have well-established benefits for pain and function.”
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Therapy for the Rheumatoid Hand
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Pouliopoulou, D. V., D’Alessandro, V., Billias, N., MacDermid, J. C., Lalone, E., Grewal, R. S., & Bobos, P. (2026) · Rheumatology Advances in Practice · doi:10.1093/rap/rkaf151
Self-citationEffects of Pilates Exercises in Rheumatological Diseases
BEKAR, Z., & Oskay, D. (2026) · İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi · doi:10.61399/ikcusbfd.1695155
Exploring the characteristics and experiences of US and Canadian hand therapists with thumb pain
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Pouliopoulou, D. V., D’Alessandro, V., Billias, N., MacDermid, J. C., Lin, Y. (., Lalone, E., Grewal, R. S., & Bobos, P. (2026) · PLoS ONE · doi:10.1371/journal.pone.0342571
“Joint protection programs (JPPs), are self-management strategies designed for patients with hand arthritis to preserve joint function, reduce pain, and delay symptom progression [7; 1].”
Self-citationMaleki, M., Saatchi, M., & Bagheri, N. (2026) · Journal of Hand Therapy · doi:10.1016/j.jht.2026.07.002
- Authors
- Bobos, P., Nazari, G., Szekeres, M., Lalone, E. A., Ferreira, L., & MacDermid, J. C.
- Affiliations
- Western University (CA)
- St Joseph's Health Care (CA)
- Corresponding author
- Bobos, Pavlos
- Venue
- Journal of Hand Therapy
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 32
- Issue
- 2
- Pages
- 194-211
- ISSN
- 0894-1130 (ISSN-L)
- OpenAlex
- W2906175097
- Cited by
- 64
- References
- 50
- Citations by year
- 2026: 7 · 2025: 3 · 2024: 22 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 10 · 2019: 9
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hand Therapy (publishedVersion)
- PubMed (publishedVersion)
- Scholarship@Western (Western University) (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- CIHR
- Topics
- Health Sciences › Medicine › Surgery › Orthopedic Surgery and Rehabilitation
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- Keywords
- joint protection, hand arthritis, hand osteoarthritis, rheumatoid arthritis, pain, hand function, grip strength, self-management interventions, usual care comparison
- MeSH terms
- Arthritis, Rheumatoid, Exercise Therapy, Humans, Ergonomics, Orthotic Devices, Osteoarthritis, Pain Measurement, Patient Education as Topic, Self-Help Devices, Hand Strength, Hand Joints
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