Two interesting studies looked at grip strength in patients with psoriatic arthritis (PsA). The first confirming that PSA is associated with poor grip strength when compared with controls (unaffected individuals), and the second showing that grip strength in the patients can be improved with a structured exercise programme.
In the first, researchers in Turkey investigated strength, proprioception (awareness of the position of fingers and hand), skill coordination and overall functional condition of the hand in 36 patients with PsA and 20 controls (ref 1). Validated questionnaires were used, together with measures of grip and pinch strength utilising a dynamometer. Coordination skills were measured by means of the Purdue Pegboard Test for finger and hand dexterity.
Compared with controls, patients with PsA had significantly weaker hands than controls. As PsA severity increased, grip strength, coordination and dexterity decreased. This study is the first to show that PsA has a negative effect on the hand - especially on hand strength.
The second study, again from Turkey, investigated the impact of a hand-focused home exercise program to improve the grip strength and functionality of the hand in 37 individuals with PsA - 29 female and 8 male (ref 2). They were allocated into two groups: Group 1 (intervention) received hand home exercises for 4-days per week for 8-weeks. Group 2 (controls) were placed on a waiting list but were given the same home exercise programme as Group 1, when the study was completed. Various measures of grip and pinch strength, together with overall functionality of the hand, were used.
At the beginning of the study there was no significant difference in any of the parameters between the two groups. After the training intervention, there were significant differences, with the exercise group having better handgrip and pinch strength, as well as overall functionality, when compared with controls. This is the first study to evaluate the impact of exercise training on hand functionality, in patients with PsA.
Comment
These are important studies which explore a neglected aspect of PsA, but one which is clearly of great importance to activities of everyday living. Anyone who has had any sort of hand injury, will be aware of how difficult it is to manage even the most routine tasks needed to get through the day. The first study showed a diminution in hand grip in patients with PsA and the second, that this can be reversed using a simple home exercise programme.
On this basis, it would seem sensible to recommend home hand exercises to those with PsA. There are any number of grip-strengthening devices readily available online and they are relatively inexpensive. A few minutes each day is all that is required to maintain hand health.
References
- Candiri B, Talu B, Karaoba DD et al. Effect of psoriatic arthritis on the strength, proprioception, skill, coordination, and functional condition of the hand. Int J Rheum Dis 2022; 25:47-55.
- Yardim S, Cetin SY, Ayang A. Investigation of the Effect of Hand Exercises on Grip Strength, in Individuals with Psoriatic Arthritis. Abstract: AB1777-HPR. Health Professionals in Rheumatology Abstracts. DOI: 10.1136/annrheumdis-2023-eular.2000