Background Patients with rheumatoid arthritis (RA) have impairment of range of motion, balance and muscle strength. Rehabilitation techniques help to improve functional status and motion activity [1–3].
Objectives To evaluate the influence of 12-month complex rehabilitation program on functional ability of patients with RA, by using hardware methods (COBS platform and EN-TreeM movement analysis).
Methods 67 patients with RA (89,6% females, age of 18 to 60 years, disease duration of 4 months to 12 years) were included and randomized into 2 groups. 35 study group patients underwent drug therapy (methotrexate or leflunomide or sulfasalazine) and complex rehabilitation: 15-min local air cryotherapy (–60°C, Criojet Air C600) for hand, knee or ankle joints, 2 courses for 10 sessions with a mean interval of 6,3 months; 45-min therapeutic exercises for large joints 3 times a week, at first under the supervision of a trainer, further own at home; 45-min occupational therapy, 10 sessions; balance training “Balloon” or “TUX RACER” on the COBS platform, 3 courses for 10 sessions with a mean interval of 3,8 months. 32 patients received only drug therapy (a control group). The COBS platform was used to measure a symmetry index and load distribution in the different modes. The average powers of knee extension and ankles flexion by the EN-TreeM movement analysis, hand grip strengths were evaluated at baseline and at 12 months.
Results 30 patients finished the rehabilitation program. After 12 months in the study group the grip strength of a more affected hand enhanced by 41,3% (p<0,05). In the patients with knee arthritis (n=21), the pressure on the COBS platform of an extremity with a more affected joint increased by 18% (p<0,05), the symmetry index – by 21% (p<0,05) in the mode “habitual stand”. The load on the limb with a more affected joint elevated by 22% (p<0,05), the symmetry index – by 28% (p<0,05) in the mode “get up and sit down”. The average extension power of a weaker knee joint increased by 86,7% (p<0,01). In the patients with ankle arthritis (n=9), the pressure on the COBS-platform of an extremity with a more affected joint enhanced by 20% (p<0,05), the symmetry index – by 23% (p<0,05) in the mode “habitual stand”. The load on the limb with a more affected joint increased by 16% (p<0,05), the symmetry index – by 26% (p<0,05) in the mode “tiptoe bounce (do not leave ground)”. The average flexion power of a weaker ankle joint increased by 77,9% (p<0,01). After 12 months in the study group there were statistically significant differences from the control group in all parameters (p<0,05).
Conclusions The COBS-platform and EN-TreeM movement analysis allow to estimate the functional status of each joint group of the lower limbs. The complex rehabilitation program improves functional ability (grip strength, power and symmetry of movements, balance and load distribution) in rheumatoid arthritis patients within 12 months.
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Vliet Vlieland TPM, van den Ende CH. Curr Opin Rheumatol 2011;23(3):259–64.
Disclosure of Interest None declared
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