Background Rheumatoid arthritis (RA) is a progressive inflammatory disease leading to joint destruction. Treatment goals include reducing pain and inflammation as well as preventing joint destruction and maintain working ability. Not only conventional and biological disease-modifying anti-rheumatic drugs (DMARDs) but also non-pharmacologic treatment, such as physiotherapy, can contribute to pain relief, reduction of inflammation, improvement in function and quality of life.

Objectives The aim of this study was to evaluate the effect of underwater ultrasound therapy on function and quality of life in RA patients. We conducted a randomized, placebo-controlled, double-blind, follow-up study.

Methods The study included 50 RA outpatients with low disease activity (3.2

Outcome measures included disease activity parameters, such as DAS28, ESR, CRP, swollen and tender joint counts; hand function assessments, as well as Health Assessment Questionnaire (HAQ) and a Self-Report Questionnaire. Study parameters were recorded at baseline, immediately after treatment and three months later.

Results Disease activity parameters, DAS28 (3.9±0.6 and 3.3±1.1 p<0.001), ESR (23.6±18.1 mm/h and 19.1±12.8 mm/h p=0.023) and CRP (11.1±9.4 mg/l and 6.0±8.3 mg/l p=0.01) showed a significant decrease from baseline to the third month in the treated group compared to the placebo group (DAS28: 4.1±0.6 and 3.8±0.8 p=0.061 ESR: 22.3±12.2 mm/h and 22.9±12.5 mm/h p=0.819 CRP: 6.1±7,8 mg/l and 6.1±7,5 mg/l p=0.987). HAQ also decreased significantly from baseline to the third month (1,3±0.8 and 1.1±0.8 p=0.018) in the treated group. Patients in both groups reported improvement in Self-Report Questionnaire either by the second week or by the third month, respectively (64% and 52% vs 61% and 61%). Hand function improved during the study period in the treated group and statistically significant improvement was revealed in the extension of the left wrist by the third month in group I (59.9±18.9 degree and 64.7±16.8 degree p=0.044).

Conclusions Underwater ultrasound treatment of patients with RAs can be an additional therapy apart from conventional and biological DMARDs resulting in improvement of function and quality of life.

Disclosure of Interest None declared