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

NCT ID: NCT07029113

Last Updated: 2025-12-10

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 54 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-07-01
• Study Completion Date: 2025-11-08

Brief Summary

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.

Detailed 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.

Conditions

Rheumatic Arthritis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Conventional Group

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.

Group Type: EXPERIMENTAL

Conventional treatment

Intervention Type: OTHER

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.

Mulligan Mobilization Group

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.

Group Type: EXPERIMENTAL

Mulligan mobilization

Intervention Type: OTHER

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.

Conventional treatment

Intervention Type: OTHER

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.

Task-Oriented Training Group

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.

Group Type: EXPERIMENTAL

Task-oriented trainig

Intervention Type: OTHER

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.

Conventional treatment

Intervention Type: OTHER

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.

Interventions

Task-oriented trainig

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.

Intervention Type: OTHER

Mulligan mobilization

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.

Intervention Type: OTHER

Conventional treatment

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.

Intervention Type: OTHER

Eligibility Criteria

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)

• Minimum Eligible Age: 30 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Kirsehir Ahi Evran Universitesi

OTHER

Sponsor Role: lead

Responsible Party

Mehmet CANLI

Lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Mehmet CANLI, PhD.

Role: STUDY_DIRECTOR

Kirsehir Ahi Evran Universitesi

Locations

Kırşehir Ahi Evran University

Kırşehir, Kırşehir, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

43834581758"

Identifier Type: -

Identifier Source: org_study_id