Does manual lymphatic drainage improve upper extremity functionality in female patients diagnosed with rheumatoid arthritis? A randomized controlled study

Akdeniz Leblebicier M., Cihan E., Şahbaz Pirinççi C., Ture A., Ari B., Ozlu A., ...More

International Journal of Rheumatic Diseases, vol.26, no.10, pp.1979-1986, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 10
  • Publication Date: 2023
  • Doi Number: 10.1111/1756-185x.14849
  • Journal Name: International Journal of Rheumatic Diseases
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Page Numbers: pp.1979-1986
  • Keywords: functionality, manual lymphatic drainage, randomized controlled trial, rheumatoid arthritis
  • Kütahya Health Sciences University Affiliated: Yes


Objective: To demonstrate the effect of manual lymphatic drainage (MLD) on upper extremity functionality in patients with rheumatoid arthritis (RA). Materials and methods: Thirty-nine female patients diagnosed with RA who were in remission were included in the study. The study group included 19 participants (mean age 50.63 ± 9.83 years), the control group included 20 participants (mean age 55.05 ± 5.89 years). The patients were randomized into two groups as home exercise program plus MLD and home exercise program alone. Both groups received treatment for 4 weeks. The primary outcome measure was pressure pain threshold (PPT). The patients were evaluated using the PPT, visual analog scale (VAS), hand–wrist joint range of motion examination, hand dynamometer and pinchmeter measurements, and the Rheumatoid Arthritis Quality of Life Scale before the interventention and at the end of the 4th week. Results: The PPT evaluated at the thumbnail, wrist, and trapezius significantly increased in the study group after treatment (p <.001, p =.001, and p <.001, respectively). MLD was found to significantly increase the PPT at the thumbnail compared with home exercise program (p =.047). The VAS score significantly decreased in the study group (p =.011). The level of increase in radial deviation was statistically higher in the study group (p =.004). Conclusion: Manual lymphatic drainage had a positive effect on pain, PPT, and range of motion in RA patients in remission. MLD can be added to medical and other conservative treatments in RA patients.