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. LEVEL OF EVIDENCE: 1b.

Influence of upper limb disability, manual dexterity and fine motor skill on general self-efficacy in institutionalized elderly with osteoarthritis.

STUDY DESIGN: Descriptive, cross-sectional. INTRODUCTION: The impact of upper limb (UL) disability, dexterity and fine motor skill on self-efficacy in older adults with osteoarthritis (OA) is not well known yet. PURPOSES OF THE STUDY: To evaluate the self-efficacy and its relationship with UL function/disability in institutionalized OA. METHODS: Institutionalized adults (n = 45) over the age of 65 years with OA were evaluated in a single session, to determine pinch strength, active range of motion of the hand and UL disability and functionality. They were classified as self-efficacious or not based on their general self-efficacy level. The influence on self-efficacy on upper limb function was statistically analyzed using bivariate and multivariate regression analyses. RESULTS: Self-effective older adults showed significantly lower scores in disability and higher scores in pinch strength, dexterity and motion of thumb than those who were classified as non-self-effective. Self-efficacy was associated with pinch strength (p ≤ 0.038), disability (p < 0.001) and dexterity (p ≤ 0.048). Multiple regression analyses showed that disability explained almost 40% of the variability of self-efficacy. CONCLUSIONS: Older adults classified as non-self-effective have higher UL disability and less pinch strength, manual dexterity and thumb motion than those who are self-effective, suggesting a relationship between impairment and perceived ability.