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THU0550 Complex Rehabilitation of Patients with Early Rheumatoid Arthritis: Results of 6-Month Program
  1. E. Orlova1,
  2. D. Karateev1,
  3. E. Nasonov2,
  4. A. Kochetkov3
  1. 1Early Arthritis department
  2. 2Research Institute of Rheumatology, Russian Academy of Medical Sciences
  3. 3Rehabilitation and Sport Medicine, Central Rehabilitation Hospital, Federal Medical Biological Agency, Moscow, Russian Federation

Abstract

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.

References

  1. Forestier R, et al. Joint Bone Spine 2009;76(6):691–8.

  2. Hurkmans EJ, et al. Rheumatology (Oxford) 2011;50(10):1879–88.

Disclosure of Interest None Declared

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