Background Rheumatoid arthritis is the most common and most serious of the inflammatory arthritides, and it dominates clinical rheumatological practice (1).This inflammation leads gradually to a destruction of bone and cartilage, responsible for loss of function (2).The main goals of treatment for RA are to prevent or control joint damage, prevent loss of function, and decrease pain (3).
Objectives The purpose of the study is to investigate the effect of task oriented training on functionality, dexterity and ADL performance in rheumatoic hands.Also the other goal of this study is to bring a new perspective to RA rehabilitation.
Methods Thirty seven women (16 patients in control group and 17 patients in study group) performed therapy programme. Control group received hand exercise therapy (MCP, DIP, PIP mobilization, range of motion exercise, isometric exercise) and study group received both hand exercise therapy and task oriented training (fork use, drinking water with a glass, face washing, sit up-stand up and t-shirt wearing) twice a week for 5 weeks. Every therapy sessions took 40–45 minutes for study group and 20–25 minutes for control group. According to the patient's condition, the rest interval was given and it was said that the exercises should not be done too fast. The results were evaluated before and after the therapy program with Jamar Hand Dynamometer, Nine Hole Peg Test, Health Assessment Questionaire and Duruöz Hand Index.
Results Age distribution of participants was 49, 57 (p>0,005) and were found to be homogeneously dispersed (p=0, 15). Hand grip strength was not statistically significant, although it increased in both groups except left hand grip strenght which was decreased after the program (control group: p=0,552 (right hand), p=0, 666 (left hand)/study group: p=0,136 (rigt hand), p=0,723 (left hand)).The NHP showed a decrease in the duration of the test within both groups, but this decrease was not statistically significant (control group: p=0,113 (right hand), p=0,265 (left hand) /study group: p=0,215 (right hand), p=0,291 (left hand). The HAQ showed a statistically significant decrease in both groups (control group: p=0,001/study group: p=0,01).Although DHI decreased in both groups, the decrease in the study group was not statistically significant (control group: p=0,003/ study group: p=0,440).Treatment efficacy between groups after treatment was evaluated by Independent-t test and change in parameters other than HAQ and DHI was not statistically significant.
Conclusions Hand exercise program and task oriented training are safe methods that can be used to increase the grip strengths of patients with rheumatoid arthritis, daily life activities and hand skills.The statistical significance of the results may be due to the low number of patients.We assume that this study can be done in a larger sample, the effect of task-oriented training on patients with rheumatoid arthritis will be better.
Emery P. Pocket Reference to Early Rheumatoid Arthritis. Springer Healthcare; 2011.
Bouysset M, Tourné Y, Tillmann K. Foot and ankle in rheumatoid arthritis.
Christie A, Jamtvedt G, Dahm KT, Moe RH, Haavardsholm E a, Hagen KB. Effectiveness of nonpharmacological and nonsurgical interventions for patients with rheumatoid arthritis: an overview of systematic reviews. Phys Ther.
Disclosure of Interest None declared