Mulligan Mobilization in Rheumatoid Hand

Rheumatoid Arthritis Clinical Trial

Official title:

Comparison of the Effects of Exercise and Protective Approach in the Rheumatoid Hand and Joint Mobilization Applications on Pain, Functional Status and Quality of Life

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05660629
• Other study ID #: Ahi Evran University
• Status: Recruiting
• Phase: N/A
• Start date: October 30, 2023
• Est. completion date: September 30, 2025

Study information

• Verified date: October 2023
• Source: Kirsehir Ahi Evran Universitesi
• Contact: Ömer Faruk Özçelep, Msc
• Phone: +90 531 946 3799
• Email: omer.ozcelep[@]ahievran.edu.tr
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 171
• Est. completion date: September 30, 2025
• Est. primary completion date: September 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 30 Years to 65 Years

Eligibility

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,

Related Conditions & MeSH terms

• Arthritis
• Arthritis, Rheumatoid
• Rheumatoid Arthritis

Intervention

Other:
• Mulligan Mobilization
Mobilization with movement (MWM) is the concurrent application of sustained accessory mobilization applied by a therapist and an active physiological movement to end range applied by the patient. Passive end-of-range overpressure, or stretching, is then delivered without pain as a barrier.

Locations

Country	Name	City	State
Turkey	Ahi Evran University	Kirsehir

Sponsors (1)

Lead Sponsor	Collaborator
Kirsehir Ahi Evran Universitesi

Country where clinical trial is conducted

Turkey, 

References & Publications (3)

Levitsky A, Kisten Y, Lind S, Nordstrom P, Hultholm H, Lyander J, Hammelin V, Gentline C, Giannakou I, Faustini F, Skillgate E, van Vollenhoven R, Sundberg T. Joint Mobilization of the Hands of Patients With Rheumatoid Arthritis: Results From an Assessor- — View Citation

Ozcelep OF, Ustun I, Algun ZC. Effect of task-oriented training on pain, functionality, and quality of life in rheumatoid arthritis. Turk J Phys Med Rehabil. 2022 Mar 1;68(1):76-83. doi: 10.5606/tftrd.2022.6666. eCollection 2022 Mar. — View Citation

Villafane JH, Cleland JA, Fernandez-de-Las-Penas C. Bilateral sensory effects of unilateral passive accessory mobilization in patients with thumb carpometacarpal osteoarthritis. J Manipulative Physiol Ther. 2013 May;36(4):232-7. doi: 10.1016/j.jmpt.2013.0 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Joint activity	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)	6 weeks
Primary	Amount of hypertrophia and effusion in wrist joints	Synovial fluid (area of hypertrophy and effusion, mm2: synovial fluid MCP/region)	6 weeks
Primary	Distance in wrist joints	the radiographic distance (mm) between the MCP or interphalangeal bone space (joint space MCP/region)	6 weeks
Primary	DAS-28	High disease activ ity >5.1, low disease activity = 3.2, remission = 2.6	6 weeks
Secondary	Determining the state of pain after treatment	Pain will be assessed using the Mcgill-Melzack Pain Questionnaire	6 weeks
Secondary	Grip force	Hand grip strength will be measured with a pinch meter and a dynamometer	6 weeks
Secondary	Range of Motion	Range of Motion will be measured with goniometer	6 weeks
Secondary	Post-treatment status of disease-related quality of life	Quality of life was assessed using the Rheumatoid Arthritis Quality of Life (RAQoL).	6 weeks
Secondary	Physical, social, and emotional well-being in RA	Arthritis Impact Measurement Scales (AIMS)	6 weeks