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Erschienen in: Zeitschrift für Rheumatologie 5/2019

15.08.2018 | Originalien

A brief report on the clinical trial on neural mobilization exercise for joint pain in patients with rheumatoid arthritis

verfasst von: BSc. (Hons) Yan Nok Lau, PhD Joseph Ng, BSc. (Hons) Shan Yee Lee, BSc. (Hons) Lam Chin Li, BSc. (Hons) Cheuk Man Kwan, BSc. (Hons) Sin Ming Fan, PhD Bernard Pui Lam Leung, MPhty Chi Ngai Lo

Erschienen in: Zeitschrift für Rheumatologie | Ausgabe 5/2019

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Abstract

Background

In rheumatoid arthritis (RA) synovitis, activation of synoviocytes and infiltration of adaptive immune cells leads to synovial hyperplasia and joint swelling. Under the elevated extra-neural pressure, free nerve endings release neuropeptides, calcitonin gene-related peptide, and substance P, thus promoting neurogenic inflammation.

Objective

This study aimed to assess the effect of therapeutic neural mobilization (NM) exercises targeting the nervous system on disease impact in RA patients.

Methods

A total of 21 RA patients were randomized into NM (n = 11) and control (n = 10) groups. NM group patients performed NM exercises targeting the median, musculocutaneous, femoral, and saphenous nerve, as well as the entire nervous system twice daily for 4–8 weeks. Control RA patients performed gentle joint mobilization exercises targeting the same joints. Primary outcome was the change in pre-/post-treatment score in the validated Rheumatoid Arthritis Impact of Disease (RAID). Secondary outcome was erythrocyte sedimentation rate (ESR).

Results

There were no significant differences between the groups at baseline. No adverse events were observed and compliance was over 90%. Post-treatment, favorable changes were observed in the NM group RAID score: −5.1 vs. −0.8; weighted RAID score: −0.79 vs. −0.15. ESR was reduced in the NM group, albeit non-significantly. Regarding the RAID score domains, the NM group demonstrated significant improvements in pain and coping.

Conclusion

The current data indicate a beneficial effect of NM exercises on pain and self-efficacy in our RA patients. Larger clinical studies are warranted to determine the clinical effectiveness of NM as a treatment for pain for RA patients and simultaneously address immune and neuropeptide modulation through NM.
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Literatur
15.
Zurück zum Zitat Butler D (2005) The neurodynamic techniques: a definitive guide from the Noigroup team, 1st edn. Butler D (2005) The neurodynamic techniques: a definitive guide from the Noigroup team, 1st edn.
Metadaten
Titel
A brief report on the clinical trial on neural mobilization exercise for joint pain in patients with rheumatoid arthritis
verfasst von
BSc. (Hons) Yan Nok Lau
PhD Joseph Ng
BSc. (Hons) Shan Yee Lee
BSc. (Hons) Lam Chin Li
BSc. (Hons) Cheuk Man Kwan
BSc. (Hons) Sin Ming Fan
PhD Bernard Pui Lam Leung
MPhty Chi Ngai Lo
Publikationsdatum
15.08.2018
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Rheumatologie / Ausgabe 5/2019
Print ISSN: 0340-1855
Elektronische ISSN: 1435-1250
DOI
https://doi.org/10.1007/s00393-018-0521-7

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