Romanowski M.W.1, Romanowski W.2, Samborski W.1
1Poznan University of Medical Sciences, Department of Rheumatology and Rehabilitation, Poznan, Poland, 2Rheumatological Centre in Srem, Srem, Poland
Background: The most common in Rheumatoid Arthritis (RA) is chronic pain that lasts more than 3 months and, unlike to acute pain is not fully physiological function. Limited joint mobility which occurs in patients with RA may be associated with abnormal muscle tension and/or destruction of articular surfaces and the formation of rheumatoid granulation and adhesions. Maitland manual mobilization is a complementary and alternative medicine (CAM) method based on passive oscillatory technique, classified from Grade I-IV with respect to intensity. It has been tested in osteoarthritic joints and found to provide pain relief and increase range of motion, but there are no published studies to date on the use of this method in RA hand joints.
Purpose: The aim of this case study was to preliminarily assess the effectiveness of the Maitland's manual mobilization method on pain and functional parameters in RA hand.
Methods: Subject age 42 with diagnosed RA. The pain occurred in both hands, which functional parameters were reduced. The Maitlands joint mobilization grade-I and grade-II were used in MCP2-5 joints and wrist joint complex (distal radio-ulnar joint, radio / ulnar-carpal joint, proximal and distal carpal rows, specific intercarpal joints) The measured outcomes were Numeric Pain Rating Scale (NPRS), Cochin Hand Function Scale (CHFS), Functional Index for Hand Osteoarthritis (FIHOA), Grip Ability test (GAT). The treatment was performed for both hands and covered 10 meetings lasting 40 minutes.
Results: Average results for both hands improved as follows pain decreased by 5 points (NPRS), time required for completing 3 tasks in GAT decreased by 47 seconds. FIHOA improved by 4 points and CHFS by 6 points.
Conclusion(s): This case study shows that Maitlands mobilization method reduces pain and improve the functional parameters of the hands in patients with RA. Positive results should encourage further research in this field.
Implications: Results from this case study encourage further research of Maitlands mobilization method and its impact on pain and functional parameters on Rheumatoid Arthritis hand which may lead to enter this form of treatment in comprehensive Physiotherapy RA patient.
Funding acknowledgements: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Topic: Musculoskeletal
Ethics approval: This study was approved by the Bioethics Committee of the University of Medical Sciences in Poznan.
All authors, affiliations and abstracts have been published as submitted.
