Effectiveness of Early Physical Therapy Rehabilitation in Patient With Juvenile Rheumatoid Arthritis

Abstract

A diverse group of idiopathic inflammatory arthritis that affects children under the age of 16 and lasts six weeks or longer is known as juvenile idiopathic arthritis (JIA) or juvenile rheumatoid arthritis (JRA). It causes joint pain and morning stiffness, and the affected joints swell and become difficult to move. During flares, patients may experience flu-like symptoms such as muscle aches and fatigue. Disease-modifying antirheumatic drugs (DMARDs) are the mainstay of rheumatoid arthritis (RA) treatment. If necessary, immunosuppressive medications can be administered in stages. Nonsteroidal anti-inflammatory drugs (NSAIDs) are pain relievers for joints. Physical therapy treatment aims to reduce pain, improve joint range, correct movement patterns, strengthen weak structures, improve cardiovascular endurance, and improve patients' quality of life. We present a case of a 12-year-old boy who presented to the hospital with knee pain and an inability to walk without assistance after falling on the ground one month prior. Medical history revealed that the patient had juvenile rheumatoid arthritis, which was confirmed on investigations. The consultant physician referred the patient for pre-rehabilitation physiotherapy before corrective surgery.

Effectiveness of Physical Therapy in Treating a Patient With Cervical Spondylosis Caused by Rheumatoid Arthritis to Improve the Quality of Life

“…In cases of severe joint inflammation, resting splints may be required at first. To prevent flexion contractures, patients with significant inflammation should engage in a daily passive full range of motion exercises [ 8 ]. As a general and nonspecific term, cervical spondylosis encompasses a wide range of conditions; however, it can be divided into three clinical syndromes for clarification: Type I (cervical radiculopathy); Type II (cervical myelopathy); and Type III (axial joint pain) [ 12 ].…”

“…There is no doubt that physical therapy is of utmost importance at all stages of the disease and represents the most effective means of preventing chronic disability [ 6 ]. Physical therapy aims to strengthen weak structures, decrease discomfort, increase joint range of motion, improve movement patterns, boost cardiovascular endurance, and enhance patients' quality of life [ 8 ]. Joint exercises should be initiated as soon as painless motion can be achieved.…”

“…The patient may initially appear rigid and inflexible at the head and neck due to growing axial neck pain with cervical spine movement. The cervical paraspinal muscles, the periscapular muscles of the neck, and/or the superior trapezius muscles frequently have sensitive "trigger" points [ 8 ].…”

“…C6-C7 are the most commonly affected levels, followed by C5-C6. Asymptomatic cervical spondylosis is generally characterized by neck pain [ 8 ].…”

A atuação fisioterapêutica em pacientes portadores da artrite reumatoide

“…Já no tratamento não farmacológico temos a ação dos fisioterapeutas, onde as condutas são realizadas com objetivo de melhorar a qualidade de vida do paciente portador da AR, sendo realizadas terapias para melhora do quadro álgico, manter e se necessário melhorar a amplitude de movimento das articulações, principalmente das afetadas, fortalecimento, correções de posturas e melhora da resistência cardiovascular 5 .…”