Cervical Stabilization Exercises in Patients With Rheumatoid Arthritis
Condition: Rheumatoid Arthritis
MeSH terms: Arthritis; Arthritis, Rheumatoid
Study type: Interventional

Summary: 
      The aim of this study is to investigate the effectiveness of cervical stabilization exercises
      on cervical positioning error in rheumatoid arthritis.
    

Detailed description: 
      Rheumatoid arthritis (RA) is a chronic, recurrent polyarthritis of the synovial joints.
      Although the prevalence of the disease shows ethnic differences, the average prevelance of
      the disease is 1%, and the female/male ratio is 2.5-3/1. The average age of onset is between
      30-50 years. Common cervical involvement in RA patients was first described by Garrod in
      1890. The most common inflammatory arthritis involving the cervical vertebra is RA. Thoracic
      and lumbar spine involvement is less common compared to cervical spine involvement in the
      disease.

      Proprioceptive sense is defined as a type of specialized sensory model that includes joint
      movement (kinesthesia) and position sense. Mechanoreceptors located in different structures
      such as muscle, tendon, joint capsule and skin in both axial joints and peripheral joints
      provide the perception of joint position and movement. The sense of proprioception provides
      dynamic joint stability and various movement skills without the need for conscious planning.
      It also prevents premature joint degeneration by preventing uncontrolled load on the joints.
      The cervical proprioceptive system consists of mechanoreceptors of the cervical
      intervertebral joints, neck muscles and vertebral ligaments, muscle spindles localized in the
      deep muscles of the cervical spine, and sensitive fibers connecting the neurons in posterior
      horn of the spinal cord to the neck proprioceptors. Cervical vertebrae, unlike the thoracic
      and lumbar regions, has an additional importance due to the abundance of mechanoreceptors
      that provide reflex connections and proprioceptive input with the vestibular central and
      central nervous systems. In previous studies, it has been shown that the sense of cervical
      proprioception is impaired in patients with chronic neck pain due to traumatic and
      degenerative causes. It has been shown that cervical proprioceptive sensory dysfunction in RA
      causes, vestibular symptoms, changes in contol of eye movements and postural disorders in
      cervical paravertebral muscles.

      No study investigating the effect of exercise on cervical proprioception in RA patients was
      found in the literature. The aim of this study was to determine the effects of cervical
      stabilization exercises on cervical proprioception in RA patients. The secondary aim of the
      present study is to evaluate the effects of cervical stabilization exercises on the
      functional status and quality of life in patients with RA.
    

Intervention name(s): Cervical stabilization exercises
Intervention type(s): Other
Intervention description(s): A progressive home-based cervical stabilization exercise program which is aimed to train deep stabilizer muscles of the cervical spine and improve coordination between superficial and deep cervical muscles will be performed by the patients for 6 weeks. Exercises are going to be delivered by sending messages and video instructions via a freeware and crossplatform messaging service (WhatsApp Messenger) in a weekly basis.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Proprioception; Exercise; Neck; Arthritis