Is a Standard Hand Rehabilitation Program Sufficient in Rheumatoid Arthritis Patients With Central Sensitization
18. května 2026 aktualizováno: Fulya Coşkun
The presence of central sensitization leads to overestimation of pain sensitivity and disease activity in rheumatoid arthritis (RA) patients.
Central sensitization should not be overlooked in RA patients to avoid over-treatment for inflammation and to determine the need for treatment of nociplastic pain.
While literature contains no studies comparing alternative programs with the standard hand rehabilitation program in the presence of central sensitization in rheumatoid arthritis patients, the objective of this study is to investigate whether desensitization exercises provide additional benefit in this patient group.
Přehled studie
Postavení
Aktivní, ne nábor
Intervence / Léčba
Detailní popis
The study is designed prospectively and will be conducted between August 22, 2025, and June 22, 2026. Patients who are regularly followed in the Physical Medicine and Rehabilitation rheumatology outpatient clinic of Haydarpasa Numune Training and Research Hospital and who meet the inclusion and exclusion criteria will be included. Demographic data such as age, height, weight, waist circumference, and diet type of participants will be recorded. At baseline, the Central Sensitization Scale, Rheumatoid Arthritis Quality of Life Scale, RA Articular Damage Score, Health Assessment Questionnaire, and Duruöz Hand Index questionnaires will be administered. DAS28 and ACR50 responses will be noted. Sedimentation and CRP values from routine follow-up files, as well as hand dynamometry and pinchmeter (lateral, palmar, and fingertip) grip strengths, will be recorded.
The study consists of one group of rheumatoid arthritis patients and two groups of rheumatoid arthritis patients with accompanying central sensitization. Group 1 (Rheumatoid Arthritis Patients) and Group 2 (Rheumatoid Arthritis Patients with Central Sensitization) will be taught determined strengthening and mobility exercises under the supervision of a physiotherapist to ensure correct home application. The investigator will also provide recorded exercise videos and handouts for patients. Group 3 (RA Patients with Central Sensitization) will additionally perform desensitization exercises 7 days a week for 3 months, in addition to the strengthening and mobility exercises. Randomization will be conducted using the sealed envelope method. Patient compliance with the exercise program will be monitored by the investigator via telephone contact on specific days of the week.
Typ studie
Intervenční
Zápis (Aktuální)
81
Fáze
- Nelze použít
Kontakty a umístění
Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.
Studijní místa
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ÜSKÜDAR
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Istanbul, ÜSKÜDAR, Turecko (Türkiye), 34674
- Haydarpaşa Numune Eğitim Ve Araştirma Hastanesi Validebağ Ek Hizmet Binasi
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Kritéria účasti
Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Ne
Popis
Inclusion *Rheumatoid Arthritis Group Without Central Sensitization (Group 1):
- Being between 18-75 years of age
- Not having had upper extremity surgery within the last 1 year
- Patients without active arthritis
- No change in medical treatment in the last 3 months
Having mild-moderate disease activity according to DAS28
*Rheumatoid Arthritis Group with Central Sensitization (Group 2):
- Being between 18-75 years of age
- Not having had upper extremity surgery within the last 1 year
- Patients without active arthritis
- No change in medical treatment in the last 3 months
Having mild-moderate disease activity according to DAS28
*Rheumatoid Arthritis Group with Central Sensitization (Group 3):
- Being between 18-75 years of age
- Not having had upper extremity surgery within the last 1 year
- Patients without active arthritis
- No change in medical treatment in the last 3 months
- Having mild-moderate disease activity according to DAS28
Criteria:
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Exclusion Criteria:
- Having had surgery on the extremity to be treated within the last 6 months
- Patients with active arthritis
- Patients with cognitive deficit
- Patients who do not consent to participate in the study
Studijní plán
Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.
Jak je studie koncipována?
Detaily designu
- Primární účel: Prevence
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
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Experimentální: Rheumatoid Arthritis Patients
SARAH Exercise
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Participants will be asked to practice home exercises every day of the week for 12 weeks.
The SARAH exercise program consists of 7 mobility and 4 strengthening exercises.
Progress will be made by increasing the repetitions and duration of the exercises every week.
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Experimentální: Rheumatoid Arthritis Patients with Central Sensitization1
SARAH Exercise
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Participants will be asked to practice home exercises every day of the week for 12 weeks.
The SARAH exercise program consists of 7 mobility and 4 strengthening exercises.
Progress will be made by increasing the repetitions and duration of the exercises every week.
|
|
Experimentální: Rheumatoid Arthritis Patients with Central Sensitization2
SARAH Exercise + Desensitization Exercises
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Participants will be asked to practice home exercises every day of the week for 12 weeks.
The SARAH exercise program consists of 7 mobility and 4 strengthening exercises.
In addition to the strengthening and mobility exercises, participants will also perform desensitization exercises 7 days a week for 3 months.
Progress will be made by increasing the repetitions and duration of the exercises every week.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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VAS
Časové okno: Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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The Visual Analog Scale (VAS) is used to assess pain intensity.
Scores range from 0 to 10, where 0 represents "no pain" and 10 represents "the worst possible pain."
Lower scores indicate a better clinical outcome.
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Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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CENTRAL DESENSİTİZATİON SCALE
Časové okno: Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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Participants were categorized based on their Central Sensitization Inventory (CSI) scores, which range from 0 (no symptoms) to 100 (extreme symptoms).
A clinical threshold was set at 40; participants scoring 40 or higher were identified as meeting the criteria for central sensitization
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Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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DURUOZ HAND INDEX
Časové okno: Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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Participants achieved a functional response based on the Duruöz Hand Index (DHI), which ranges from 0 (best outcome) to 90 (worst outcome).
A response was defined as a significant reduction in the total score from baseline, where lower scores indicate improved hand function and independence in daily activities.
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Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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Dynamometer-measured hand grip strength measurements (kg)
Časové okno: Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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Hand grip strength was measured using a calibrated dynamometer to assess isometric muscle strength.
Results are reported in kilograms (kg).
On this scale, higher values indicate greater muscle strength and better physical performance (best outcome), while lower values indicate reduced grip strength (worst outcome).
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Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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Pinchmeter-measured finger strength measurements (kg) (Tip, Lateral, Palmar)
Časové okno: Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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Finger pinch strength was measured using a calibrated pinchmeter to evaluate fine motor strength in three positions: Tip pinch (thumb to index finger), Lateral pinch (thumb to the radial side of the index finger), and Palmar pinch (thumb to index and middle fingers).
Measurements are recorded in kilograms (kg).
Higher values indicate greater functional strength and better hand performance (best outcome), whereas lower values indicate reduced pinch force (worst outcome).
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Assessments will be conducted at baseline, at the end of the 3-month exercise program, and at the 6-month follow-up.
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Spolupracovníci a vyšetřovatelé
Zde najdete lidi a organizace zapojené do této studie.
Sponzor
Publikace a užitečné odkazy
Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.
Obecné publikace
- Williams MA, Srikesavan C, Heine PJ, Bruce J, Brosseau L, Hoxey-Thomas N, Lamb SE. Exercise for rheumatoid arthritis of the hand. Cochrane Database Syst Rev. 2018 Jul 31;7(7):CD003832. doi: 10.1002/14651858.CD003832.pub3.
- England BR, Smith BJ, Baker NA, Barton JL, Oatis CA, Guyatt G, Anandarajah A, Carandang K, Chan KK, Constien D, Davidson E, Dodge CV, Bemis-Dougherty A, Everett S, Fisher N, Fraenkel L, Goodman SM, Lewis J, Menzies V, Moreland LW, Navarro-Millan I, Patterson S, Phillips LR, Shah N, Singh N, White D, AlHeresh R, Barbour KE, Bye T, Guglielmo D, Haberman R, Johnson T, Kleiner A, Lane CY, Li LC, Master H, Pinto D, Poole JL, Steinbarger K, Sztubinski D, Thoma L, Tsaltskan V, Turgunbaev M, Wells C, Turner AS, Treadwell JR. 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2023 Aug;75(8):1603-1615. doi: 10.1002/acr.25117. Epub 2023 May 25.
- Mesci N, Mesci E, Kandemir EU, Kulcu DG, Celik T. Impact of central sensitization on clinical parameters in patients with rheumatoid arthritis. North Clin Istanb. 2024 Apr 22;11(2):140-146. doi: 10.14744/nci.2023.81231. eCollection 2024.
Užitečné odkazy
Termíny studijních záznamů
Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.
Hlavní termíny studia
Začátek studia (Aktuální)
22. srpna 2025
Primární dokončení (Aktuální)
22. prosince 2025
Dokončení studie (Odhadovaný)
22. června 2026
Termíny zápisu do studia
První předloženo
12. května 2026
První předloženo, které splnilo kritéria kontroly kvality
18. května 2026
První zveřejněno (Aktuální)
20. května 2026
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
20. května 2026
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
18. května 2026
Naposledy ověřeno
1. května 2026
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- 2024KAEK18-5048
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