An interventional study of Task-oriented trainig and Mulligan mobilization in Rheumatic Arthritis, sponsored by Kirsehir Ahi Evran Universitesi. Completed at 1 site in Turkey (Türkiye). Open to participants aged 30 Years to 65 Years. Per ClinicalTrials.gov, last updated 2025-12-10.
Sponsored by Kirsehir Ahi Evran Universitesi · Not applicable, Interventional, and Treatment
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.
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.
62 studies on the registry are indexed under Rheumatic Fever; 20 are open to participants now.
This study's enrollment of 54 is below the median of 70 across 28 interventional studies indexed under Rheumatic Fever.
Browse Rheumatic Fever studies →Kirsehir Ahi Evran Universitesi is the lead sponsor of 133 studies on the registry; 55 are open to participants now.
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Exclusion Criteria:
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.
Other: Conventional treatment
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.
Other: Mulligan mobilization · Other: Conventional treatment
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.
Other: Task-oriented trainig · Other: Conventional treatment
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.
In patients included in the Mulligan mobilisation group, the therapist will apply a dorsal shift from the distal radius to the carpal bones and the patient simultaneously extends the wrist. It is essential that the movement is painless; if any pain occurs during mobilisation, the direction or technique is re-evaluated. This application is performed in 8-10 repetitions and the frequency of the session is planned according to the patient's symptoms.
Passive range of motion exercises, metacarpopalangeal, proximal interphalangeal and distal interphalangeal joint mobilisation and isometric exercises will be applied. Isometric exercises will be performed as 30 repetitions, while joint mobilisations will be performed by the therapist as moderate anteroposterior and mediolateral shifts.
Evaluation of Hand Grip Strength
Hand grip strength of the participants was measured with a hand dynamometer (Takei Scientific Instruments Co., Ltd., Japan). During the test application, the standard positioning rules determined by the American Association of Hand Therapists will be followed. Accordingly, the participant will be ensured to be in an upright sitting position and the consistency of the measurements will be maintained by not allowing the arms to be supported.
Time frame: 5 week
Evaluation of Hand Functions
Nine-Hole Peg Test and Duruöz Hand Index will be used for the evaluation of hand functions. The Nine-Hole Peg Test is a practical and rapidly applicable manual skill measurement method with scientifically proven validity and reliability. The Duruöz Hand Index was first developed in 1996 to assess hand function in patients with Rheumatoid Arthritis. Since then, it has been shown to be valid and reliable in a wide range of upper extremity conditions. It consists of 18 questions.
Time frame: 5 week
Evaluation of Pain Severity
The pain intensity of the participants will be evaluated with the McGill-Melzack Pain Questionnaire.
Time frame: 5 week
Assessment of Quality of Life
The Rheumatoid Arthritis Quality of Life Questionnaire will be used to assess patient-specific symptoms and the impact of the disease on life. The Rheumatoid Arthritis Quality of Life Scale is a unique 30-item quality of life assessment tool for RA patients developed in parallel studies in the UK and the Netherlands.
Time frame: 5 week
Disease Activity
The Disease Activity Score-28 (DAS-28) is a widely used measure in clinical settings to assess disease activity in individuals with RA. The score is derived from the number of swollen and tender joints in the patient's 28 joints, the acute-phase reactants (erythrocyte sedimentation rate, ESR, or CRP), and a 0-100 mm visual analog scale (VAS) score that reflects the patient's overall health status. The DAS-28 score categorizes disease activity as low, moderate, or high.
Time frame: 5 week
Plan to share: No
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Kirsehir Ahi Evran Universitesi