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THU0559 Comparative Efficiency of Four Rehabilitation Programs for Patients with Early Rheumatoid Arthritis
  1. E. Orlova1,
  2. D. Karateev2,
  3. L. Denisov1,
  4. A. Kochetkov3,
  5. E. Nasonov4
  1. 1Laboratory of Clinical Trials
  2. 2Early Arthritis department, Nasonova Research Institute of Rheumatology
  3. 3Rehabilitation and Sport Medicine, Central Rehabilitation Hospital, Federal Medical Biological Agency
  4. 4Nasonova Research Institute of Rheumatology, Moscow, Russian Federation

Abstract

Background Rheumatoid arthritis (RA) requires long term management by drug treatments, rehabilitation techniques and cooperation of the multidisciplinary team [1–3].

Objectives To compare the efficacy of four rehabilitation programs for patients with early RA within 6 months.

Methods 128 patients with early RA (85,9% females, age of 18 to 63 years, disease duration of 2 to 19 months) were included. 34 patients (group 1) underwent drug therapy and complex rehabilitation program (hospital stage for 2 weeks: local air cryotherapy (−60°C, Criojet Air C600) for hand, knee or ankle joints for 15 min, 45-min therapeutic exercises for joints 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 lessons) and outpatient stage for 6 months: 45-min home exercises 3 times a week, orthoses (functional wrist and knee orthoses, individual orthopedic insoles)). At hospital stage 31 patients (group 2) received local air cryotherapy, therapeutic exercises and occupational therapy; the home-based exercises lasted for 6 months 3 times a week. At hospital stage 15 patients (group 3) underwent 10 high-intensity dynamic exercises using gym apparatus Enraf-Nonius for 45–60 min (aerobic part (En-Cardio) and 18–20 muscle-strengthening exercises (En-Dynamic Track)), 18 patients (group 4) – 10 therapeutic exercises for 45 min, at outpatient stage the both exercise programs lasted for 6 months 3 times a week. 30 patients (control) received only drug therapy. Tender and swollen joint count, 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 and at 6 months.

Results At baseline there were no statistically significant differences in all parameters between the 5 groups (p>0,05). After 6 months there were the best achievements of most parameters in the group 1 (p<0,05).

Conclusions Individual complex rehabilitation program, including different elements of the multidisciplinary service (physiotherapy, physical exercises, occupational therapy, education program and orthoses), provides the maximum positive effect on functional ability, motion activity, quality of life and diseases activity in patients with early RA within 6 months.

References

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

  2. Luqmani R, et al. Rheumatology 2006;45(9):1167–9.

  3. Hurkmans EJ, et al. Acta Reumatol Port 2011;36(2):146–58.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.3821

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