The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine
Online ISSN : 1884-3697
Print ISSN : 0029-0343
ISSN-L : 0029-0343
Section2 [ Hot and cold stimuli 2 ]
02-3 Local cryotherapy, physical exercises, occupational therapy, orthoses and therapeutic education in complex rehabilitation of patients with early rheumatoid arthritis
Evgeniya ORLOVADmitry KARATEEVLev DENISOVAndrey KOCHETKOV
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2014 Volume 77 Issue 5 Pages 427-428

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Abstract

Objectives: To evaluate the efficacy of complex rehabilitation program for patients with early rheumatoid arthritis (RA) within 6 months.
Patients and Methods: 64 patients with early RA were included. 34 study group patients underwent drug therapy and complex rehabilitation. The rehabilitation program consisted of hospital stage (2 weeks): local air cryotherapy (-60°C, Criojet Air С600) 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, methods for shaping a correct functional stereotype, use of assistive devices and adaptive equipment for personal care, mobility and household), 10 sessions, education program (4 daily 90-min studies) and outpatient stage (6 months): 45-min home-based exercises 3 times a week, orthoses (functional wrist and knee orthoses, individual orthopedic insoles). 30 patients received only drug therapy (control). Tender and swollen joint count, erythrocyte sedimentation rate (ESR), joint pain on 100-mm visual analogue scale (VAS), Disease Activity Score (DAS28), Stanford Health Assessment Questionnaire (HAQ), Rheumatology Assessment Patient Index Data (RAPID3), hand grip strength, the average powers of knee extension and ankle flexion by EN-TreeM movement analysis were evaluated at baseline, at 2 weeks and at 6 months.
Results: 2-week stationary stage of rehabilitation program relieved pain, improved parameters of functional status and motor activity, but did not influence on the parameters of inflammatory diseases activity (swollen joint count, ESR, DAS28) (table). After 6-month complex rehabilitation program tender joint count decreased by 72.3%, swollen joint count - by 74.1%, ESR - by 58.2%, joint pain by 70.4%, DAS28 - by 1.38±0.2, HAQ - by 0.97±0.56, RAPID3 - by 5.98±1.25 (p<0.01). The grip strength of a more affected hand elevated by 44.9%, the average extension power of a weaker knee joint - by 88.7%, the average flexion power of a more affected ankle joint - by 81.6% (p<0.01). The changes in the control group were less pronounced, which determined statistically significant differences between the groups in all parameters (p<0.05).
Conclusion: 6-month complex rehabilitation program increases functional ability and motion activity, relieves pain, helps to control diseases activity and improves quality of life in patients with early RA.

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© 2014 The Japanese Society Balneology, Climatology and Physical Medicine
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