Effect of traditional Chinese Yijinjing exercise on hand dysfunction in rheumatoid arthritis patients: a randomized controlled trial

Abstract

Background: Rheumatoid arthritis (RA) patients suffer from hand dysfunction. Exercise has been shown to affect pain, function and quality of life, as recommended by guidelines. Yijinjing is a traditional Chinese exercise that is beneficial to mind-body health. This study aimed to evaluate the efficacy and safety of Yijinjing for preventing hand dysfunction in RA patients. Methods: This was a single-center, randomized controlled trial (RCT) in which the outcome assessors were blinded. RA participants who met the eligibility criteria (n = 66) were randomly assigned to the exercise (n = 33) or control (n = 33) group. The former underwent professional Yijinjing exercise three times a week for 12 weeks. The latter maintained ordinary activities without intervention. All outcomes, including the Michigan Hand Function Scale (MHQ), handgrip strength, active range of motion (AROM), RA disease activity (DAS28-ESR), Health Assessment Questionnaire Disability Index (HAQ), anxiety and depression mental status, and wrist ultrasound, were obtained at baseline and after 12 weeks. Results: The MHQs of the exercise group significantly improved compared with those in the control group at 12 weeks (p<0.05), with improvements in handgrip strength and active joint range of motion (wrist extension, radial deviation, and metacarpophalangeal flexion) (p<0.05). Although the difference was not statistically significant, the ultrasound score of the exercise group did not increase (p>0.05). The morning stiffness duration, DAS28-ESR, ESR, and CRP level were significantly greater in the exercise group than in the control group (p<0.05). For the quality of life, anxiety, and depression scores, both groups presented improvements compared with the baseline group (p<0.05), while the exercise group was clearly better than the control group (p<0.05). Following the 12-week intervention, neither group experienced any adverse events or substantial abnormalities in their vital signs according to ECG. Conclusion: Yijinjing exercise can improve hand function and enhance handgrip strength and flexibility in RA patients with low disease activity while ameliorating quality of life and alleviating anxiety and depression while safe and not aggravating joint inflammation. Clinical trial registration: [https://clinicaltrials.gov/study/NCT05527158], Identifier [NCT05527158].