Özcelep Ömer Faruk, Üstün Işıl, Algun Z Candan
Department of Physiotherapy and Rehabilitation, Gökçem Rehabilitation Center, Istanbul, Turkey.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Turk J Phys Med Rehabil. 2022 Mar 1;68(1):76-83. doi: 10.5606/tftrd.2022.6666. eCollection 2022 Mar.
The aim of this study was to demonstrate additional effects of task-oriented training (TOT) in patients with rheumatoid arthritis (RA) regarding pain, dexterity, muscle strength, and ability to perform activities of daily living (ADLs) within five weeks.
Between June 2016 and February 2018, a total of 46 female RA patients (mean age: 51.17±7.9 years; range, 29 to 68 years) who were volunteer for participating in the study were randomized into two groups as follows: conventional exercise group (Group 1) and conventional + TOT group (Group 2). The exercises of Group 1 included passive range of motion (PROM), isometric grip strength exercises, and mobilization of metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints. In Group 2, in addition to conventional exercises, the patients completed an exercise program consisting of washing their faces, using forks, drinking water from a glass, sitting up, and putting on a shirt. Exercises were performed twice a week for a five-week period. Before and after the exercise programs, hand grip strength was assessed with a Jamar hand dynamometer, hand dexterity with Nine Hole Peg Test (NHPT), pain with Visual Analog Scale (VAS), and ADLs with Health Assessment Questionnaire (HAQ) and Duruöz Hand Index (DHI).
There was no significant difference in NHPT and Jamar in both groups (p>0.05). Although a significant decrease was observed within the groups in VAS and HAQ scores before and after the exercise programs in both groups (p<0.05), no significant difference was found between the groups (p>0.05). The DHI showed a significant improvement in Group 2 and a significant difference was observed between the two groups (p<0.05).
This study shows that exercise programs may be beneficial in alleviating pain and performing daily activities. Also, adding task-oriented training to a program may facilitate ADLs in RA patients.
本研究旨在证明面向任务的训练（TOT）对类风湿性关节炎（RA）患者在五周内的疼痛、灵活性、肌肉力量及日常生活活动（ADL）能力方面的额外效果。
2016年6月至2018年2月期间，共有46名自愿参与本研究的女性RA患者（平均年龄：51.17±7.9岁；范围29至68岁）被随机分为两组：传统运动组（第1组）和传统运动 + TOT组（第2组）。第1组的运动包括被动关节活动度（PROM）、等长握力训练以及掌指关节、近端指间关节和远端指间关节的松动术。在第2组中，除了传统运动外，患者还完成了一个包括洗脸、使用餐叉、用杯子喝水、坐起和穿衬衫的运动项目。运动每周进行两次，为期五周。在运动项目前后，使用Jamar握力计评估握力，用九孔插板试验（NHPT）评估手部灵活性，用视觉模拟评分法（VAS）评估疼痛，并用健康评估问卷（HAQ）和杜罗兹手部指数（DHI）评估ADL。
两组的NHPT和Jamar无显著差异（p>0.05）。尽管两组运动项目前后组内VAS和HAQ评分均有显著下降（p<0.05），但两组间无显著差异（p>0.05）。DHI显示第2组有显著改善，且两组间存在显著差异（p<0.05）。
本研究表明运动项目可能有助于减轻疼痛和进行日常活动。此外，在项目中加入面向任务的训练可能会促进RA患者的ADL。
