Joint mobilization of the hands in rheumatoid arthritis: an assessor-blinded, randomized crossover study

Not Applicable

Completed

• Conditions: Rheumatoid arthritis; Hand osteoarthritis; Physical Medicine / Rehabilitation - Other physical medicine / rehabilitation; Inflammatory and Immune System - Rheumatoid arthritis; Alternative and Complementary Medicine - Other alternative and complementary medicine

• Registration Number: ACTRN12617000696392
• Lead Sponsor: Ronald van Vollenhoven

Brief Summary

Background: Despite major advances in treating rheumatoid arthritis (RA) with disease-modifying antirheumatic drugs, a considerable number of patients still experience chronic pain. Novel, integrative approaches are thus warranted. Aim: The purpose of this study was to assess the clinical feasibility, safety, and effectiveness of Kaltenborn manual mobilization of the hands in RA. Methods: Twelve participants with RA and eight with hand osteoarthritis (OA) as a clinical comparator group were recruited to receive low-grade (I-II) Kaltenborn manual mobilization for 1 month, with a follow-up at month 2. One hand per participant was randomized to receive treatment at weeks 1 and 2. The control hand was crossed over to receive treatment at weeks 3 and 4. Clinical outcome measures such as hand pain by visual analog scale was assessed together with inflammation and radiographic joint space with musculoskeletal ultrasound. Key findings: Regardless of which hand was treated, hand pain, inflammation and joint space improved in the RA group from baseline to crossover to follow-up at 2 months. Hand pain and joint space also improved in OA. No dropouts or adverse events were reported in either the RA or OA group. Conclusions: Manual mobilization of the hands in RA was shown to be feasible, safe, and effective to integrate into specialized healthcare.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Completion: 2017-02-08
• Study Start: 2017-05-15
• Last Update Posted: 15 July 2019

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

Daily bilateral hand pain; diagnosis of rheumatoid arthritis or hand osteoarthritis at least six months prior to inclusion.

Exclusion Criteria

Chronic bone damage or soft tissue injuries in the hands; acute hand inflammation within the latest week; surgery on the shoulder, arm, or hand within the latest 3 months of any kind; pregnancy within the latest 3 months.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Pain by 100mm visual analog scale (VAS) MCP II-V hand pain (composite)[Baseline; Week 2, 3, 4; Follow-up (2 months)];MCP II-V hand Doppler signal (composite) by musculoskeletal ultrasound[Baseline; Week 2, 3, 4; Follow-up (2 months)];MCP II-V radiographic joint space (composite) by musculoskeletal ultrasound[Baseline; Week 2, 3, 4; Follow-up (2 months)]