Any treatment of rheumatic diseases without physical therapy (PT) is always incomplete, and PT can not be replaced by anything else. Furthermore, joint and spine mobility and function can only be obtained or improved by PT options. The underlying mechanisms of clinical improvement through PT are so far only partly known. Methods of molecular medicine now facilitate analysis of central mediators of the inflammatory process which include the interactions between bone cells and the immune system, and the effects of PT.
Therefore, in this lecture the following selected studies are presented:
1. Acute haemodynamic response to carbon dioxide hand immersion in patients with systemic sclerosis evaluated by Doppler ultrasonography. Key messages: CO2 hand immersion is a simple, inexpensive way to improve distal digital blood flow without any side effects.
2. The effects of manual mobilisation (MM) on the mobility of the thoracic spine in patients with ankylosing spondylitis. Key messages: MM of the thoracic spine promotes mobility, improves respiratory function and positively affects disease activity, functional, and global status.
3. Safety and efficacy of whole-body vibrations (WBV) as add-on therapy to pharmacological treatment of postmenopausal osteoporosis. Key messages: WBV appears to be a valuable addition for the symptomatic treatment of low back pain and fall risk in postmenopausal osteoporosis.
4. Efficacy of intensive physical therapy in combination with low-dose etanercept (ETA) in active spondyloarthritis. Key messages: The concept of combining intensive physical therapy with low-dose administration of ETA was effective and therefore represents a useful alternative, especially in terms of cost savings.
5. The impact of serial low-dose radon and hyperthermia exposure (sRH) in a therapeutic adit on pivotal cytokines of bone metabolism and clinical parameters in ankylosing spondylitis. Key messages: sRH result in a reduction of osteocatabolic and an increase of osteoanabolic cytokine levels, which represents the molecular basis for inhibiting osteoclastic activity in secondary osteoporosis. Therefore, sRH results in significant long-term pain reduction for 6 months.
In summary, it is possible to achieve a significant relief of rheumatic symptoms with PT. These studies demonstrate for the first time possible explanations for the efficacy of PT on the molecular level. The essential importance of PT in the multimodal treatment concept of rheumatic diseases is thus emphazied.
Disclosure of Interest None declared
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