Article

Rehabilitation slows the progress of rheumatoid arthritis (RA) and prevents
progression of disability.
This study aimed to compare the impact of two
rehabilitation programmes on pain, disease activity, locomotor function, global
health and work ability forecast in RA patients. METHODS:
Sixty-four employed women aged 24-65 years participated in the study. All
patients underwent individual and instrumental kinesiotherapy. Thirty-two
patients underwent cryogenic chamber therapy and local cryotherapy as well as
non-weight-bearing, instrumental and individual kinesiotherapy. The remaining 32
patients received traditional rehabilitation in the form of electromagnetic and
instrumental therapy, individual and pool-based non-weight-bearing
kinesiotherapy. Rehabilitation lasted 3 weeks. Patients were examined three
times: prior to rehabilitation, after 3 weeks of therapy and 3 months after
completion of rehabilitation. The following study instruments were used: to
assess disease activity: DAS-28; functional impairment: HAQ-DI; pain severity:
VAS; patients' overall well-being: a scale from 0 to 100 (Global Health Index);
and patients' own prognosis of fitness for work: the 6th question from Work
Ability Index (WAI). Statistical analysis of data was performed using the
STATISTICA 8.0 package. Mixed-design two-way analysis of variance was used for
hypothesis testing. RESULTS: All patients improved after rehabilitation. The
group of patients those who underwent cryotherapy had improved DAS-28, HAQ-DI,
VAS and global health scores immediately following the 3-week rehabilitation
programme (p < 0.001, p = 0.001, p = 0.007 and p < 0.001, respectively), as well
as at the 3-month follow-up (p < 0.001, p < 0.001, p = 0.009 and p < 0.001,
respectively). Rehabilitation using cryotherapy resulted in greater improvement
in disease activity DAS-28 [F(2,105) = 5.700; p = 0.007; eta(2) = 0.084] and
HAQ-DI locomotor function scores [F(2,109) = 6.771; p = 0.003; eta(2) = 0.098]
compared to traditional rehabilitation. The impact of both forms of
rehabilitation on patients' own prognosis of work ability in the next 2 years was
not significant. Results of patients who underwent traditional approach showed
decreased disease activity following the initial 3-week period; however, this
improvement did not sustain to the end of follow-up, 3 months later. CONCLUSIONS:
Complex rehabilitation in RA has a positive effect on patients' clinical
condition. The rehabilitation programme that includes cryotherapy overtops
traditional rehabilitation, particularly as regards improvement in locomotor
function, disease activity and sustaining willingness to continue working and
exerts long-lasting effect. Implications for Rehabilitation Rehabilitation using
cryotherapy is more effective in improving locomotor function, decreasing disease
activity and sustaining willingness to continue working compared to traditional
rehabilitation. Rehabilitation using cryotherapy significantly reduces the
intensity of pain experienced by patients with RA, and this positive effect is
maintained at 3 months post-rehabilitation. Complex rehabilitation, particularly
treatment using cryotherapy, improves patients' subjective assessment of their
overall well-being and perception of their disease. Complex rehabilitation in
rheumatoid arthritis has a positive effect on patients' clinical condition.

Langue : ANGLAIS