Effect of Task-Specific Hand Dexterity Circuit Training as an Adjunct to Conventional Physiotherapy on Pain and Functional Disability in Individuals with Rheumatoid Arthritis: A Quasi-Experimental Study

Abstract

Background: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder predominantly affecting small joints of the hands, leading to pain, deformity, and functional disability. Conventional physiotherapy focuses primarily on pain relief and strengthening; however, structured task-specific dexterity training targeting functional hand activities remains underexplored.
Objective: To evaluate the effect of task-specific hand dexterity circuit training as an adjunct to conventional physiotherapy on pain and functional disability in individuals with rheumatoid arthritis.
Methods: A quasi-experimental comparative study was conducted over 12 months in a tertiary care teaching hospital. One hundred participants diagnosed with RA (ACR/EULAR 2010 criteria) were recruited through convenience sampling and allocated into experimental (n=50) and control (n=50) groups. Both groups received supervised physiotherapy sessions (40 minutes/day, 5 days/week) for four weeks. The control group received conventional physiotherapy, while the experimental group received 15 minutes of conventional therapy followed by 25 minutes of task-specific hand dexterity circuit training. Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS) and functional disability using the Health Assessment Questionnaire Disability Index (HAQ-DI). Paired and independent t-tests were used for statistical analysis (p<0.05).
Results: Both groups showed significant within-group improvements (p<0.001). The experimental group demonstrated greater reduction in NPRS (6.9±1.2 to 3.1±0.9) compared to the control group (6.8±1.1 to 4.8±1.0). HAQ-DI scores improved significantly in the experimental group (1.86±0.38 to 1.15±0.26) compared to the control group (1.82±0.36 to 1.50±0.32) (p<0.001).
Conclusion: Task-specific hand dexterity circuit training combined with conventional physiotherapy provides clinically meaningful improvements in pain and functional disability in individuals with rheumatoid arthritis.