Table 2 Exercise programme for people with hand osteoarthritis

1.

Shoulder extension: Sit on an armless chair, knees slightly flexed, and heels on the floor. Start position: hands partly pronated (thumb up), close to the knees. Pull the exercise band back, as the hands follow the thigh to the iliac crest.

2.

Biceps curl: Stand with the feet shoulder width apart, arms hanging down. Hands are supinated (thumb laterally). Bend both elbows, pulling the exercise band towards the shoulders.

3.

Shoulder flexion: Stand with the feet shoulder width apart, arms hanging down. Hands are pronated (thumb medially). Keep the elbows extended and lift the arms to face level.

4.

Make an “O-sign”: Keep the thumb IP and MCP joints slightly flexed throughout. First, open the hand as if grabbing a bottle. Bring the index finger tip to the thumb tip, keeping the MCP, PIP and DIP joints flexed. Open the hand again (“grab the bottle”). Repeat with the 3rd, 4th and 5th fingers.

5.

Roll into a fist: First, flex the 2nd to 5th DIPs and PIPs only (keep the MCPs extended). Then flex the MCPs. Hold for 5 seconds. Reverse: extend the MCPs only, then the PIPs and DIPs.

6.

Thumb abduction/extension: Put one or more small elastic band(s) around the 1st to 5th proximal phalanges. Rest the loose fist, pronated, on a flat surface. Keep the thumb MCP and IP joints flexed and abduct/extend the thumb. Hold for 5 seconds.

7.

Grip strength: Squeeze a pipe insulation tube as hard as possible (isometric hold) for 10 seconds.

8.

Finger stretch: Lay the right hand on a flat surface. Use the left hand to apply firm pressure for 30 seconds stretching the 2nd to 5th PIP and DIP joints. Repeat 2 times for each hand.

If the finger joints are painful: stretch one finger at a time; place the 2nd to 4th finger tips (opposite hand) between the finger joints of the 2nd finger; press for 30 seconds.