Background Rehabilitation techniques give the people with rheumatoid arthritis (RA) the strategies necessary to manage their disease in addition to medical treatment [1, 2]. However, the efficiency of early rehabilitation of RA patients remains a controversial area in rheumatology.
Objectives To evaluate the efficacy of complex rehabilitation program for patients with early RA within 6 months.
Methods 60 patients with early RA (88,3% females, age of 18 to 63 years, disease duration of 2 to 18 months) were included. 34 study group patients underwent drug therapy and rehabilitation program (hospital stage (2 weeks): local air cryotherapy (–60°C, Criojet Air C600) for hand, knee or ankle joints for 15 min, 45-min therapeutic exercises under the supervision of a trainer, 45-min occupational therapy (joint protection strategies, use of assistive devices and adaptive equipment), 10 sessions, education program (4 daily 90-min studies) and outpatient stage (6 months): 45-min home exercises 3 times a week, orthoses (functional wrist and knee orthoses, individual orthopedic insoles)). 26 patients received only drug therapy (control). Tender and swollen joint count, erythrocyte sedimentation rate (ESR), joint pain on 100-mm VAS, DAS28, HAQ, RAPID3, hand grip strength, the average powers of knee extension and ankle flexion by the EN-TreeM movement analysis were evaluated at baseline, at 2 weeks and at 6 months.
Results The rehabilitation reduced needs for nonsteroidal anti-inflammatory drugs by 32,3% (p<0,05), enhanced adherence to joint protection strategies by 10,5 times (p<0,01), orthosis wearing by 44,4–72,7% (p<0,01), regular physical activity by 4,5 times (p<0,01). 22 patients finished 6-month rehabilitation.
Conclusions 6-month rehabilitation increases compliance to non-drug therapies, improves functional ability, motion activity and quality of life, reduces diseases activity in patients with early RA. The main reason for interruption of the rehabilitation is a low adherence to non-drug treatments, primarily – to home-based exercises.
Forestier R, et al. Joint Bone Spine 2009;76(6):691–8.
Hurkmans EJ, et al. Rheumatology (Oxford) 2011;50(10):1879–88.
Disclosure of Interest None Declared