| Rheumatoid arthritis (RA) is a chronic,
| |
| | prevent joint stress, support joints, and
|
| progressive disease which may lead to
| |
| | decrease joint stiffness.
|
| considerable disability. While there are
| |
| | Wrist splints and ring splints are useful
|
| no cures for RA, recent developments in
| |
| | for reducing inflammation and preventing
|
| biologic therapy make it possible to
| |
| | deformity in the hands.
|
| place many patients into remission.
| |
| | Joint stress in the feet can be reduced
|
| In addition to medications though, it is
| |
| | by using a supporting pad at the sole of
|
| important to add adjunctive treatments
| |
| | the foot and by using metatarsal pads.
|
| such as physical therapy and
| |
| | Visco-elastic soles may help reduce shock
|
| rehabilitation which help to increase
| |
| | loading occurring in the legs with
|
| functional capacity, provide pain relief,
| |
| | walking.
|
| and also provide patient education.
| |
| | For RA patients with serious neck
|
| Before starting therapy, physical
| |
| | involvement, particularly with the first
|
| assessments should include: functional
| |
| | and second vertebrae, a Philadelphia
|
| assessments (what the patient is capable
| |
| | collar may be needed. The Philadelphia
|
| of at the present time), range of motion,
| |
| | device provides excellent immobilization
|
| muscle strength, posture, and level of
| |
| | and may be used in the presence of neck
|
| fitness.
| |
| | instability.
|
| Cold and hot modalities are the most
| |
| | Patients using compression gloves have
|
| commonly used physical treatments in
| |
| | reported reduced joint swelling and pain
|
| arthritis therapy. Cold application is
| |
| | but there is no hard evidence that they
|
| mostly used in acute stages whereas hot
| |
| | improve grip strength or hand function.
|
| is used in chronic stages of RA.
| |
| | Improvement may be provided by using
|
| Heat works because it induces analgesia,
| |
| | compression gloves both during the day as
|
| relieves muscle spasm, and improves
| |
| | well as at night in patients with
|
| flexibility. Heat can be used before
| |
| | inflammation in their hands or fingers.
|
| exercise to help loosen muscles and
| |
| | Occupational therapy interventions such
|
| joints. Heat treatment may be applied as
| |
| | as assistive devices and adaptive
|
| a hot-pack, infrared radiation,
| |
| | equipments have beneficial effects on
|
| diathermy, paraffin, or hydrotherapy.
| |
| | joint protection and energy conservation
|
| Applications are recommended for 10-20
| |
| | in arthritic patients. Assistive devices
|
| minutes once or twice a day. Caution
| |
| | are used in order to improve functioning,
|
| should be exercised in patients with
| |
| | reduce pain, and keep patients self
|
| nerve damage, impaired circulation, or
| |
| | sufficient.
|
| diabetes, since there is a risk of
| |
| | Loading over the hip joint may be reduced
|
| thermal injury.
| |
| | by about 50% by using a cane. Elevated
|
| Cold therapy is preferred in active
| |
| | toilet seats, widened gripping handles,
|
| joints where inflammation is
| |
| | bathroom adjustments all help improve
|
| uncontrolled. Cold packs, ice, nitrogen
| |
| | activities of daily living.
|
| spray, and cryotherapy are different ways
| |
| | Massage is used to improve general well
|
| of applying cold-therapy.
| |
| | being and help diminish swelling of
|
| Cartilage-destroying enzymes such as
| |
| | inflamed joints. Massage can help with
|
| collagenase, elastase, hyaluronidase, and
| |
| | depression, anxiety, mood, and pain.
|
| protease are produced in the inflamed
| |
| | Muscle weakness in patients with RA
|
| joints of patients with RA. Levels of
| |
| | occurs as a result of immobilization or
|
| these enzymes are affected by the
| |
| | reduction in activities of daily living.
|
| temperature within joints. Increasing
| |
| | Maintenance of normal muscle strength is
|
| temperature inside the joint leads to an
| |
| | important not only for physical function
|
| increase in collagenase activity and
| |
| | but also for stabilization of the joints
|
| cartilage damage.
| |
| | and prophylaxis of traumatic injuries.
|
| Electrostimulation is used in patients
| |
| | Exercise therapy has beneficial effects
|
| with RA to relieve pain. Transcutaneous
| |
| | on RA by improving endurance and
|
| electrical nerve stimulation (TENS)
| |
| | enhancing fitness.
|
| therapy is the most commonly used method.
| |
| | Things to consider before launching an
|
| TENS is a short-acting therapy and it
| |
| | exercise program include: whether the
|
| also has a high placebo effect.
| |
| | involvement of the joints is local or
|
| Water therapy, also known as hydrotherapy
| |
| | systemic, disease stage, patient age, and
|
| or "balneotherapy" has been used for
| |
| | patient compliance.
|
| arthritis since ancient times.
| |
| | Range of motion exercises, stretching,
|
| Objectives of hydrotherapy are to
| |
| | strengthening, aerobic conditioning
|
| increase range of motion, strengthen
| |
| | exercises, and routine daily activities
|
| muscles, relieve painful muscle spasms,
| |
| | all should be included in a comprehensive
|
| and improve a patient's well-being.
| |
| | exercise program.
|
| There have been studies showing
| |
| | Every joint should be moved in full range
|
| beneficial effects of hydrotherapy with
| |
| | of motion at least once per day in order
|
| pain reduction and improvement in grip
| |
| | to prevent contracture. In the case of
|
| strength. Because of buoyancy, water
| |
| | acutely inflamed joints, isometric
|
| therapy allows patients to perform
| |
| | exercises provide muscle tone without
|
| exercise without undue joint stress. Some
| |
| | worsening disease activity.
|
| studies have shown that hydrotherapy
| |
| | If the disease activity is minor, then
|
| leads to muscle, tendon, and ligament
| |
| | isotonic exercises should be performed by
|
| relaxation and a feeling of well-being.
| |
| | using very low weights. If pain persists
|
| Endorphin release may also contribute to
| |
| | more than 2 hours or too much fatigue,
|
| improved pain control.
| |
| | loss of strength, or increase in joint
|
| Some have suggested that water therapy
| |
| | swelling occurs after an exercise
|
| may have beneficial immune system
| |
| | program, then the program should be made
|
| benefits with reduction in
| |
| | less intense. Walking can aggravate knee
|
| pro-inflammatory cytokines.
| |
| | pain in patients with active
|
| Physical and occupational therapists
| |
| | inflammation. Therefore, patients with
|
| educate patients in joint protection
| |
| | active RA should avoid activities such as
|
| strategies, use of assistive devices, and
| |
| | climbing stairs or weight lifting.
|
| performance of therapeutic exercises.
| |
| | Producing excessive stress over the
|
| Joints should be put at rest during the
| |
| | tendons during the stretching exercises
|
| acute phase of the disease. Bed rest
| |
| | should be avoided.
|
| relieves the pain in cases of extensive
| |
| | When arthritis is controlled medically,
|
| joint involvement. It is critical, at
| |
| | conditioning exercises such as swimming,
|
| this stage, to put the joints into rest
| |
| | walking, using an elliptical trainer, and
|
| at a functional position. Fortunately,
| |
| | cycling with adequate resting periods are
|
| bed rest is not needed as much as it once
| |
| | recommended. They increase muscle
|
| was. Splints are used to keep involved
| |
| | endurance and aerobic capacity and
|
| joints in a functional position. Splints
| |
| | improve function of the patient, and they
|
| help to mitigate pain and inflammation,
| |
| | also make the patient feel better.
|
| prevent development of deformities,
| |
| |
|
