Mulligan Mobilization in Rheumatoid Hand

Not Applicable

Completed

• Conditions: Rheumatoid Arthritis
• Interventions: Other: Mulligan Mobilization

• Registration Number: NCT05660629
• Lead Sponsor: Kirsehir Ahi Evran Universitesi

Brief Summary

The goal of this randomized-controlled study is to learn about the effectiveness of the Mulligan mobilization in rheumatoid hands. The main question it aims to answer are:

-Does mulligan mobilization reduce effusion in wrist joints with rheumatoid arthritis? Participants will take Mulligan mobilization application and active ROM exercises for their hands. Researcher will compare treatments group ith sham mobilization.

Detailed Description

Rheumatoid arthritis (RA) is a systemic disease that can lead to chronic pain, bone and soft tissue damage, and disability retirement. Alleviating pain and maintaining joint range of motion in RA are important for reducing disability. Joint mobilizations are manual therapy techniques used to increase range of motion and reduce pain. The aim of this study is to investigate the effects of rheumatoid hand exercise and protective approach and joint mobilization applications on pain, functional status and quality of life.

Study Timeline

• Study First Submitted: 2022-11-30
• Study First Submitted QC: 2022-12-13
• Study First Posted: 2022-12-21
• Study Start: 2023-10-30
• Status Verified: 2024-12
• Primary Completion: 2024-12-11
• Study Completion: 2024-12-12
• Last Update Submitted: 2024-12-13
• Last Update Posted: 2024-12-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 21

Inclusion Criteria

• Having been diagnosed with RAS according to ACR and EULAR criteria,
• Being under the control of a physiatrist for at least 1 year,
• Have not had any upper extremity surgery in the last 6 months
• Have the cognitive capacity to understand commands,
• Not to be involved in any other rehabilitation program or study,

Exclusion Criteria

• Presence of soft tissue injury and chronic bone damage in the hand,
• Presence of acute inflammation in any joint in the previous week,
• Presence of a degenerative or non-degenerative neurological condition that causes a change in pain perception,

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Mulligan Mobilization	Mulligan Mobilization	Rehabilitation Program (Active wrist ROM exercises): * Forearm pronation and supination * Wrist flexion and extension * Wrist flexion and extension (in the form of a fist) * MCP Joint Flexion and Extension * Thumb IC joint Flexion and Extension * Abduction and Adduction of Fingers These exercises will be performed by the physiotherapist in the form of 5 seconds of movement / 15 seconds of rest, 10 repetitions a day, 5 days a week for 6 weeks. Mulligan Mobilization: * Carpal Medio-lateral Glide (open kinetics, wrist flexion and extension movement) * Carpal Rotation (open kinetics, wrist flexion and extension) * Scaphoid Antero-posterior Glide (open kinetics) * Metacarpal Antero-posterior Glide (When Clenching) * Medio-lateral Glide to PIP-DIP joints (open kinetics, fingers flexed)
Sham Mobilization	Mulligan Mobilization	Participants will receive sham mobilization in addition to the ROM exercises given in the Mulligan group. Sham mobilization will be done in the same position as Mulligan but without any glide force.

Primary Outcome Measures

Name	Time	Method
Amount of hypertrophia and effusion in wrist joints	6 weeks	Synovial fluid (area of hypertrophy and effusion, mm2: synovial fluid MCP/region)
Distance in wrist joints	6 weeks	the radiographic distance (mm) between the MCP or interphalangeal bone space (joint space MCP/region)
DAS-28	6 weeks	High disease activ ity \>5.1, low disease activity ≤ 3.2, remission ≤ 2.6
Joint activity	6 weeks	Primary outcomes included the automated quantification (Q) of joint activity using color Doppler pixel count calculations (% hyperemia/blood flow activity score within an inflamed joint: color Q-Doppler MCP/region)

Secondary Outcome Measures

Name	Time	Method
Grip force	6 weeks	Hand grip strength will be measured with a pinch meter and a dynamometer
Post-treatment status of disease-related quality of life	6 weeks	Quality of life was assessed using the Rheumatoid Arthritis Quality of Life (RAQoL).
Physical, social, and emotional well-being in RA	6 weeks	Arthritis Impact Measurement Scales (AIMS)
Determining the state of pain after treatment	6 weeks	Pain will be assessed using the Mcgill-Melzack Pain Questionnaire
Range of Motion	6 weeks	Range of Motion will be measured with goniometer

Trial Locations

Locations (1)

Ahi Evran University; 🇹🇷 Kırşehir, Turkey