| Registry | NCT07754552 |
|---|---|
| Status | Not yet recruiting |
| Phase | Not applicable |
| Study type | Interventional; randomized, parallel, masking: single, treatment |
| Enrollment | 132 (Estimated) |
| Sponsor | Istanbul University - Cerrahpasa (Other) |
| Conditions | Rheumatoid Arthritis, Rheumatoid Arthritis (RA, Rheumatoid Arthritis (RA) Prevention |
| Interventions | SMART-HAND Protocol, Conventional Hand Rehabilitation, Joint Protection and Ergonomic Education (Behavioral) |
| Dates | start 2026-10-01 (estimated), primary completion 2027-12-28 (estimated), completion 2027-12-30 (estimated), first posted 2026-08-10, last updated 2026-08-14 |
Related Papers Related Patents Related Grants Related Experts
All trials for Rheumatoid Arthritis All trials for Rheumatoid Arthritis (RA All trials of SMART-HAND Protocol All trials of Conventional Hand Rehabilitation
Rheumatoid arthritis (RA) frequently affects the hand and wrist, resulting in pain, reduced joint stability, impaired proprioception, muscle weakness, and limitations in daily activities. Although conventional rehabilitation primarily focuses on range of motion and strengthening exercises, sensorimotor impairments such as proprioceptive deficits are often underaddressed. The SMART-HAND (Sensory, Massage, Approximation, ROM, Training = Strengthening + Perturbation) protocol was developed as a structured, mechanism-based rehabilitation program to improve proprioception, joint stability, motor control, and hand function. This randomized controlled trial aims to evaluate the effectiveness of the SMART-HAND protocol in individuals with RA by comparing its effects on hand function, proprioception, pain, dexterity, muscle strength, and functional performance with conventional rehabilitation and a control group.
| Arm | Type | Interventions | Description |
|---|---|---|---|
| SMART-HAND Protocol | Experimental | Behavioral: SMART-HAND Protocol | Participants assigned to the SMART-HAND Protocol Group will receive a supervised 12-week hand rehabilitation program consisting of two 50-minute sessions per week (24 sessions in total). The SMART-HAND protocol includes massage, sensory training, joint approximation, range of motion exercises, stretching, strengthening exercises, and perturbation-based stabilization training. Exercise progression will be individualized according to participants' tolerance using the Borg Rating of Perceived Exertion scale and progressive resistance. The intervention is designed to improve proprioception, sensorimotor integration, dynamic joint stability, muscle strength, and hand function. |
| Conventional Hand Rehabilitation Group | Active comparator | Behavioral: Conventional Hand Rehabilitation | Participants assigned to the Conventional Hand Rehabilitation Group will receive a supervised 12-week conventional hand exercise program consisting of two 50-minute sessions per week (24 sessions in total). The program includes range of motion, stretching, and strengthening exercises. Exercise intensity and progression will be individualized according to participants' tolerance using the Borg Rating of Perceived Exertion scale and progressive resistance. The intervention primarily aims to improve joint mobility, muscle strength, and hand function. |
| Usual Care + Education Group | Active comparator | Behavioral: SMART-HAND Protocol; Behavioral: Joint Protection and Ergonomic Education | Participants assigned to the Usual Care + Education Group will continue to receive their routine medical care and will attend a single educational session lasting approximately 20-30 minutes. The education will include joint protection principles, ergonomic recommendations, and strategies for performing activities of daily living. No supervised exercise program will be provided during the 12-week study period. |
Sex: All, ages: 18 Years to any
Inclusion Criteria: * Participants will be 18 years of age or older. * Participants will have a diagnosis of rheumatoid arthritis for at least five years. * Participants will be referred by a rheumatologist. * Participants will have been on a stable medication regimen for the past three months. * Participants will have no history of diabetes mellitus. * Participants will have no other conditions affecting sensory function. * Participants will provide informed consent to participate in the study. Exclusion Criteria: * Individuals who have undergone hand surgery within the past six months. * Individuals with a history of upper extremity fracture within the past six months. * Individuals with other musculoskeletal pain conditions involving the muscles and/or joints. * Individuals diagnosed with a neurological disease that may affect sensory or motor function. * Individuals who are unable to fully cooperate with the assessment procedures. * Individuals who have received corticosteroid treatment within the past month. * Individuals diagnosed with another rheumatic disease. * Pregnant women. * Individuals who are illiterate. Withdrawal/Discontinuation Criteria * Participants who miss more than 10% of the intervention sessions will be excluded from the study. * Participants who change their medication dosage or medication class during the study period will be excluded from the study. * Participants will have the right to withdraw from the study at any time and for any reason.