Comparing the effects of two occupational therapy programmes on selected indicators in women with rheumatoid arthritis: a randomised controlled trial
摘要
Rheumatoid arthritis is one of the most common autoimmune diseases in the world. That is why new effective methods for the conservative treatment of this disease are constantly being sought. Unfortunately, there is still a lack of scientific reports on the effective use of occupational therapy as a method of conservative treatment among this group of individuals. Therefore, the aim of our research is to compare the effectiveness of two occupational therapeutic programmes based on art therapy and computer technology among women with rheumatoid arthritis. A group of 55 women between the age of 50–70 years with diagnosed rheumatoid arthritis in remission, with a disease duration between five and 10 years took, part in the research. Participants were randomly (a coin toss, performed by the main author) assigned to one of three groups: Group P (Pablo® System therapy), Group A (art therapy), and Group C (control, no therapeutic intervention). All of the examined women were residents of the same large city, the average age in the examined groups being: Group P – 59.95 years, Group A – 61.79 years, and Group C – 61.47 years. The original therapeutic programme in Groups P and A was carried out individually with each patient, three times a week, for six weeks. The primary outcomes were to measure body mass (Tanita scale), body height (Martin type anthropometer) and identify the most difficult activity to perform (Canadian Occupational Performance Measure Questionnaire). The effects of therapy were assessed using the 25 Hole Pegboard Test (dexterity and hand-eye coordination), the Pablo® System (range of motion in the wrists: extension, flexion, intra-radial adduction and ulnar adduction), the Numeric Rating Scale (pain intensity) and the 36-Item Short Form Health Survey (quality of life). The research project was a quantitative study, lasting from October to December 2025. It was conducted at the Occupational Therapy Workshop, part of the Central Research Laboratory of the University of Physical Culture in Kraków, Poland. Statistical analysis was performed using the t -test for dependent samples and one-way analysis of variance (ANOVA). Women from the study groups did not differ statistically significantly in terms of age, body mass, body height or Body Mass Index. Statistically significant results for comparisons between measurements were obtained in Group P for the dominant limb: dexterity (p < 0.001; 29.82–32.57 95%CI), wrist extension (p < 0.001; 57.86–65.40 95% CI), wrist flexion (p < 0.001; 64.70–71.40 95%CI), wrist intra-radial adduction (p < 0.001; 15.69–17.46 95%CI), wrist ulnar adduction (p < 0.001), and for the non-dominant limb: dexterity (p < 0.001; 29.59–32.43 95% CI), wrist extension (p < 0.001; 58.25–66.38 95%CI), wrist flexion (p < 0.001; 66.61–72.02 95%CI), wrist intra-radial adduction (p < 0.001; 15.28–17.14 95%CI) and wrist ulnar adduction (p < 0.001; 25.41–32.80 95%CI). For Group P, statistically significant results were also observed in comparisons between measurements of pain intensity (p < 0.001; 3.02–3.82) and in the physical area of quality of life (p < 0.026; 48.38–54.02). In Group A, such changes were observed only in pain intensity (p = 0.011; 3.72–4.59 95%CI). The results obtained during the study suggest that occupational therapy using the Pablo system may be more effective than art therapy in improving upper limb function among women with rheumatoid arthritis, especially in terms of functional parameters and quality of life regarding its physical component.