INTRODUCTION: Rheumatoid arthritis patients often experience significant hand dysfunction. Yijinjing, a traditional Chinese exercise, has been recognized for its benefits to mind-body health. This study aimed to evaluate the efficacy and safety of Yijinjing in improving hand dysfunction among individuals with rheumatoid arthritis. METHODS: This research was conducted as a single-center, outcome-blinded, randomized controlled trial. A total of 66 eligible rheumatoid arthritis participants were randomly assigned in a 1:1 ratio to either the Yijinjing exercise group with sessions conducted three times per week over a 12-week period or the control group, which maintained ordinary activities. Various outcomes were assessed, including the Michigan Hand Outcomes Questionnaire, handgrip strength, active range of motion, rheumatoid arthritis disease activity, the Health Assessment Questionnaire Disability Index, levels of anxiety and depression, and wrist ultrasound, all of which were collected at baseline and at week 12. RESULTS: At the end of the 12 weeks, the Yijinjing exercise group demonstrated significant improvements in Michigan Hand Outcomes Questionnaire scores compared to the control group (p < 0.05), alongside enhancements in handgrip strength and active range of motion, specifically in wrist extension, radial deviation, and metacarpophalangeal flexion (p < 0.05). Wrist ultrasound scores did not exhibit a significant increase in the Yijinjing exercise group, meaning no inflammation aggravation (p > 0.05). Additionally, morning stiffness duration, Disease Activity Score 28-ESR, erythrocyte sedimentation rate, and C-reactive protein levels showed significant improvement in the Yijinjing exercise group (p < 0.05). Both groups reported enhancements in quality of life, as well as reductions in anxiety and depression scores, with the Yijinjing exercise group displaying greater improvements overall (p < 0.05). Importantly, no adverse events or significant abnormalities in vital signs were observed in either group. CONCLUSION: Yijinjing exercise may effectively enhance hand function, handgrip strength, and flexibility in rheumatoid arthritis patients with low disease activity. Furthermore, it appears to improve quality of life and reduce anxiety and depression without exacerbating joint inflammation. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT05527158, identifier NCT05527158.

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