Effects of Task-Oriented Training and Mulligan Mobilization on Hand Function, Pain and Quality of Life in Patients With Rheumatoid Arthritis

Kirsehir Ahi Evran Universitesi

Status: Invitation-only

Conditions: Rheumatic Arthritis

Treatments: Other: Task-oriented trainig; Other: Mulligan mobilization; Other: Conventional treatment

Study type: Interventional

Funder types: Other

Identifiers

NCT07029113

43834581758"

Details and patient eligibility

About

Rheumatoid arthritis (RA) is a chronic and progressive inflammatory disease that frequently affects the hand joints. Over time, this disease leads to joint deformities, pain, decreased muscle strength and severe impairment in hand function. Functions such as independence in activities of daily living, hand skills and grip strength may be significantly limited in individuals with RA. Although hand rehabilitation is an important component of RA management, there is still a need for research on effective intervention strategies.

Full description

Rheumatoid arthritis (RA) is a chronic and progressive inflammatory disease that frequently affects the hand joints. Over time, this disease leads to joint deformities, pain, decreased muscle strength and severe impairment in hand function. Functions such as independence in activities of daily living, hand skills and grip strength may be significantly limited in individuals with RA. Although hand rehabilitation is an important component of RA management, there is still a need for research on effective intervention strategies.

Conventional exercises are basic applications to maintain range of motion, muscle strength and endurance. However, these approaches may have limited effects on improving hand function. In recent years, methods such as task-oriented training and Mulligan mobilisation have gained attention for their potential to improve neuromotor control, hand dexterity and pain. Task-oriented training promotes motor learning through functional tasks, while Mulligan mobilisation aims to increase mobility through pain-free passive-joint mobilisation techniques. The effects of these two methods, separately or in combination, on hand function, pain level and quality of life in individuals with RA have not been adequately investigated.

The aim of this study was to investigate the effects of task-focused training and Mulligan mobilisation on hand function, grip strength, dexterity, pain, activities of daily living and quality of life in individuals with RA.

Enrollment: 54 estimated patients

Sex: All

Ages: 30 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Followed for at least one year for the diagnosis of Rheumatoid Arthritis, aged between 30 and 65,
• Have the cognitive capacity to understand and follow the instructions given,
• Has not undergone upper extremity surgery for orthopaedic, neurological or other reasons
• Participants with functional capacity class I-II

Exclusion criteria

• Severe pain as assessed by Visual Analogue Scale (VAS) (VAS >7),
• Declaring the intention to withdraw from the study without giving any reason,
• Having a major psychiatric disorder such as schizophrenia or major depression,
• Having cardiovascular diseases such as coronary artery disease, history of myocardial infarction, angina, stroke, uncontrolled hypertension, chronic obstructive pulmonary disease (COPD)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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54 participants in 3 patient groups

Conventional Group

Experimental group

Description:

Conventional Group, the patients performed passive range of motion (PROM) exercises, mobilization of MCP, PIP and distal interphalangeal (DIP) joints and isometric exercises. While PROM and isometric exercises were applied in 30 repetitions, joint mobilizations were performed by the therapist with moderate severity in the form of anteroposterior and mediolateral gliding.

Treatment:

Other: Conventional treatment

Mulligan Mobilization Group

Experimental group

Description:

In the Mulligan mobilisation group, the therapist will apply a dorsal shift from the distal radius to the carpal bones and the patient will simultaneously extend the wrist. It is essential that the movement is painless; if any pain occurs during mobilisation, the direction or technique will be re-evaluated. This application will be performed in 8-10 repetitions and the frequency of the session will be planned according to the patient's symptoms.

Treatment:

Other: Conventional treatment

Other: Mulligan mobilization

Task-Oriented Training Group

Experimental group

Description:

In addition to MCP, PIP, DIP joint mobilisation and isometric exercises, the task-oriented training group will perform 30 repetitions of face washing, using a fork, drinking water with a glass, sitting and wearing a t-shirt exercises.

Treatment:

Other: Conventional treatment

Other: Task-oriented trainig