| Background:Rheumatoid Arthritis(RA)is a chronic,systemic,inflammatory autoimmune disease characterized by joint synovial as the target tissue.It is often manifested as symmetric polyarthritis,hand involvement manifested as morning stiffness,joint swelling,joint pain,terminal joint stiffness,deformity and dysfunction,with a high disability rate.Drug therapy can effectively control the disease,but it can not be cured.However in the course of the disease,rehabilitation and functional exercise is an important adjuvant therapy.At present,for the hand functions of RA patients in China,finger exercises is a very common rehabilitation exercise instruction.As another kind of rehabilitation trainings,resistance training can improve muscle quality,delay muscle aging,improve speed,flexibility,coordination and other sports qualities.Therefore,this study will conduct hand-finger and resistance training intervention in patients with RA due to hand-weakened strength of the disease to explore their impact on the functional rehabilitation of RA patients.Objective:With the finger exercises and resistance training intervention,to compare the difference of hand grip strength,morning stiffness time and Signals of Functional Impairment(SOFI)between the experimental group and control group,before and after intervention in the experimental group.Methods:Sixty-six patients of rheumatoid arthritis in the middle and low levels of activity were enrolled in the Department of Rheumatology,Peking Union Medical College Hospital from October 2016 to March 2017.The patients were divided into a control group(33 cases)and an experimental group(33 cases)according to their visit order.Two groups of patients were conducted the hand-finger exercises with manuals.At the same time,the experimental group was conducted an extra resistance training intervention three times every week,with a manual and a Hand Function Training Mesh delivered as the resistance training tool.The progress and training videos were tracked via Wechat.The total training time is three months.As a comparison,the grip strength and hand morning stiffness of the two groups were collected and tested before and 3 months after the intervention.And the hand function of the patients was evaluated by the Signals of Functional Impairment(SOFI).T-test and Nonparametric tests were used to evaluate the effect for the experimental group before and after the intervention,and including(1)the grip strength of the experimental group increased from 85.0(49.3,108.7)mmHg to 89between the experimental group and the control group.Results:In this study,a total of 66 subjects had completed the data collection,including 33 cases in the control group and 33 cases in the experimental group.The results showed that significant improvements were made after three months of hand manipulation and resistance training intervention,.5(56.0,119.0)mmHg after the intervention.Moreover,the duration of morning stiffness was shortened from 45.0(30.0,60.0)to 10.0(5.0,15.0)minutes,and the SOFI score decreased from 2.0(1.0,3.0)to 1.0(0.0,1.0).(2)Compared with the control group,the grip strength of experimental group 89.5(56.0,119.0)mmHg was increased significantly than that of the control group 60.0(40.5,102.7)mmHg with P<0.05,and the duration of morning stiffness of the experimental group10.0(5.0,15.0)minutes was shortened even more significantly comparing with the control group 30.0(10.0,45.0)minutes with P<0.01,and the SOFI 1.0(0.0,1.0)score was improved significantly than that of control group 1.0(1.0,2.0)with P<0.01.Conclusion:Finger exercises and resistance training intervention can effectively improve the function of hand joints in patients with rheumatoid arthritis,including grip strength,morning stiffness time and the score of Signals of Functional Impairment,which is a worthy promotion in large-scale for the rheumatoid patients who were in the middle and low levels of activity in China as a rehabilitation nursing intervention. |
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