Blood flow restriction training for hand osteoarthritis: A randomised controlled trial

INTERVENTION: Arm 1: Blood flow restriction exercise. Training period: 6 weeks. Training frequency: 3 days per week. Exercise mode: Thumb abductors/extensors, interosseous, pinching, gripping muscle exercises. Training intensity: 30% to 40% of maximum voluntarily contraction. A physiotherapist will prescribe the exercises. Blood flow restriction will be applied using a pneumatic cuff with a handheld sphygmomanometer. The cuff will be applied to the arm, proximally to the muscles exercised. The cuff will provide an individualised restriction of the blood flow, but will not cause arterial occlusion. Participants will be individually supervised throughout the training session by a physiotherapist, ensuring adherence and safety. Each exercise session will last approximately 30 minutes. The blood flow restriction exercise group will receive education about disease through a brochure provided after group randomisation. Arm 2: Traditional high intensity exercise. Training period: 6 weeks. Training frequency: 3 days per week. Exercise mode: Thumb abductors/extensors, interosseous, pinching, gripping muscle exercises. Training intensity: 60% to 70% of maximum voluntarily contraction. The same physiotherapist as for arm 1 will prescribe the exercises. The traditional high intensity group will undertake exercise without blood flow restriction, and without application of a blood flow restriction cuff. Each exercise session will last approximately 30 minutes. The traditional high intensity exercise group will receive education about disease through a brochure provided after group randomisation. CONDITION: Hand osteoarthritis PRIMARY OUTCOME: Hand pain, 11‐points Numerical Pain Rating Scale (NRS). Maximum grip strength (kg), hand held dynamometer. OARSI‐OMERACT responder criteria SECONDARY OUTCOME: Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Exercise induced pain, 11‐point NRS. Functional Index of Hand Osteoarthritis (FIHOA). Hand left/right judgment task and a control left/right judgement task Participant's intervention acceptability, using a 6 points Likert scale Patient specific functional scale (PFSF). INCLUSION CRITERIA: Symptomatic and radiographic hand osteoarthritis.