Rheumatoid arthritis (RA) frequently affects the hand and wrist, resulting in pain, reduced joint stability, impaired proprioception, muscle weakness, and limitations in daily activities. Although conventional rehabilitation primarily focuses on range of motion and strengthening exercises, sensorimotor impairments such as proprioceptive deficits are often underaddressed. The SMART-HAND (Sensory, Massage, Approximation, ROM, Training = Strengthening + Perturbation) protocol was developed as a structured, mechanism-based rehabilitation program to improve proprioception, joint stability, motor control, and hand function. This randomized controlled trial aims to evaluate the effectiveness of the SMART-HAND protocol in individuals with RA by comparing its effects on hand function, proprioception, pain, dexterity, muscle strength, and functional performance with conventional rehabilitation and a control group.
Participants will be 18 years of age or older.
Participants will have a diagnosis of rheumatoid arthritis for at least five years.
Participants will be referred by a rheumatologist.
Participants will have been on a stable medication regimen for the past three months.
Individuals who have undergone hand surgery within the past six months.
Individuals with a history of upper extremity fracture within the past six months.
Individuals with other musculoskeletal pain conditions involving the muscles and/or joints.
Individuals diagnosed with a neurological disease that may affect sensory or motor function.