Introduction: Rheumatoid arthritis is a polyarticular chronic inflammatory disease of the joints. The main symptoms of the disease are pain, swelling and stiffness of the joints. The most important long-term consequence in the musculoskeletal system is inflammatory damage to the joints, which significantly impairs functional capacity and therefore the performance of daily tasks. Increased physical activity and therapeutic exercise can be used in combination with pharmacological and physical therapies to effectively relieve symptoms with significant benefits in controlling joint inflammation, maintaining joint mobility, reducing structural damage, and therefore maintaining joint function and improving physical capacity. Purpose: The purpose of this review was to analyse the effectiveness of different therapeutic upper limb exercise programmes on pain reduction and grip strength improvement in patients with rheumatoid arthritis. Methods: We reviewed the literature in the PubMed, Cinahl, Cochrane Library and PEDro databases. The following keywords were used in different combinations: kinesiotherapy, exercise, strength training, physical activity, hand, upper limb, rheumatoid arthritis. Results: Five studies were included in the literature review. In all studies, subjects in experimental groups performed different therapeutic exercise programmes for the arms and/or upper limbs. The exercise programmes varied in type, duration, frequency and intensity. In the four studies, the exercise programme consisted of supervised exercise sessions under the guidance of a physiotherapist and exercises in the home environment. In one study, the exercise programme was entirely performed in the home environment. A statistically significant reduction in pain between groups was found in one study, and a statistically significant improvement in grip strength was found in two studies. A statistically significant reduction in pain and improvement in hand grip strength within groups occurred in one study. Discussion and conclusion: In conclusion, therapeutic exercise for the upper limb plays an important role in the management of rheumatoid arthritis patients due to its positive effect on both pain reduction and improvement of grip strength, however, because of the heterogeneity of exercise programmes, we cannot recommend the most effective exercise programme. Therefore, a standardised exercise protocol should be developed in the future to facilitate implementation in the clinical setting. Future research should include longer exercise programmes and define the optimal exercise parameters in more detail.
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