Pain Neuroscience Education and Vagus Nerve Stimulation on Recovery in Individuals With Rheumatoid Arthritis

13-item questionnaire, based on personal feedback, assesses the severity of patients' reactions to pain on a scale of 0-4. The validity and reliability of the questionnaire in Turkish has been established.

Assesses disease activity in 28 different joints. Blood draws will be performed by a specialist physician who diagnoses patients, conducts regular checkups, and then refers suitable patients to a physical therapist. A score below 2.6 indicates the disease is in remission; scores between 2.6 and 3.1 indicate low disease activity; scores between 3.1 and 5.1 indicate moderate disease activity; and scores above 5.1 indicate high disease activity.

The patient's personal information, medical treatment history, current lifestyle, and exercise habits will be inquired about using a form specifically designed for the specific disease.

Developed by Melzack in 1987, the questionnaire assesses chronic pain in three sections: pain characteristics, severity, and intensity, has also been validated in Turkish and is recommended for use in rheumatological patients. The Turkish validation of the questionnaire was conducted by Yavuz et al. in 2007, and it was found to be valid in Turkish. Higher score indicates severe pain severity.

The pressure pain threshold (PPT), defined as the minimum pressure stimulus applied to elicit pain, is suitable for measuring pain in RA. Pain thresholds will be measured using an algometer at the third metacarpophalangeal (MCP) joints, the wrist, and the most inflamed joints.

Indicates how frequently patients use behavioral and cognitive methods to cope with pain. The questionnaire, consisting of 6 subscales (active and passive), inquires about patients' orientations during painful situations. Items are scored on a 4-point Likert scale, with 1 being the least frequent use of pain management measures and 4 being the most frequent.

Published in 1995 to measure fear of movement and re-injury, the questionnaire consists of 17 items. Questions address areas such as fear of re-injury and avoidance of movement. A score of 17 is the lowest possible score, and indicates no kinesiophobia or negligible.

Examines the various dimensions of the effects of RA on fatigue. It was developed in 2010. The questionnaire consists of four subcategories: physical fatigue in the last 7 days, fatigue in activities of daily living, and cognitive and emotional fatigue. Patients receive scores between 0 and 70 on the 20-question questionnaire, with higher scores indicating higher fatigue.

19-item scale questions subjective sleep quality over the past month. The total score ranges from 0 to 21, with a higher score indicating poor sleep quality. A Turkish version of the scale is available and is used in rheumatological diseases.

30-item scale, with valid and reliable Turkish versions, is a published quality of life questionnaire specific to rheumatoid arthritis. Higher scores indicate lower quality of life.

To examine the relationship between pain and joint range of motion, goniometry measurements will be taken at the four most commonly affected areas: the atlantoaxial joint, shoulder joint, wrist joint, and ankle with the degree of movement.

Circumference measurements will be taken at the hand, finger, and ankle to assess inflammation in the centimeter measures.

Participants in the PNE group will be asked to answer 10 multiple-choice questions covering the presentation topics. This will provide information about the level of understanding of the information presented within the PNE group and its impact on the pain questionnaires, according to the score they take out of the total score of 100.