title: Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial.
abstract: BACKGROUND
  Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging.
  
  
  METHODS
  The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann-Whitney U test.
  
  
  CONCLUSIONS
  The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task-oriented training compared with conventional hand exercises in people with rheumatoid arthritis or osteoarthritis of the hand.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01635582.
authors.affiliation: Department of Physical Therapy, School of Medical Rehabilitation, Faculty of Medicine, University of Manitoba, R106 - 771 Mc Dermot Avenue, Winnipeg, Manitoba R3E 0T6, Canada.
authors.forename: Cynthia Swarnalatha
authors.initials: CS
authors.lastname: Srikesavan
authors.forename: Barbara
authors.initials: B
authors.lastname: Shay
authors.forename: David B
authors.initials: DB
authors.lastname: Robinson
authors.forename: Tony
authors.initials: T
authors.lastname: Szturm
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D001696:Biomechanical Phenomena; D002985:Clinical Protocols; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D050823:Hand Joints / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D009043:Motor Activity; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010349:Patient Compliance; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome; D018910:Video Games