Romatoid Artrit Tedavisinde Akuaterapinin Etkinliği

Abstract

Objective: Rheumatoid Arthritis (RA) is a chronic destructive inflammatory disorder. This study is aimed to investigate the effects of balneotherapy and aquatherapy in the treatment of RA patients. Materials and Methods: A total of 59 patients who fulfilled the American College of Rheumatology diagnostic criteria for RA were included this study. Patients were randomly assigned into three groups. Group 1 (n=20) received balneotherapy, group 2 (n=20) received an aquatic exercise program and group 3 (n=19) was accepted as control group. These programs were applied five times a week, over three weeks (15 sessions). Patients were evaluated for clinical and laboratory parameters. Clinical parameters included pain,duration of morning stiffness, number of swollen and tender joints, disease activity score (DAS28), Modified health assessment questionnaire (mHAQ), physician's and patient's global assessment and hand grip strength. Laboratory evaluation included erythrocyte sedimentation rate(ESR) and C-reactive protein (CRP). The assessment parameters were measured before, at the end of and after 3 months of the therapy. Results: The mean age of the patients was 54±10.7 (25-75) years and the mean disease duration was 122.3±98.1 (1-424) months. In aquatic exercise group we observed an improvement in DAS28 scores (p<0.001), in the number of tender joints (p<0.005), in VAS scores (p<0.005), mHAQ (p<0.05), physician's and patient's global assessments (p<0.05). Also there was a statistically significant decrease in ESR results in aquatherapy group compared to other groups (p<0.05). However no statistically significant difference was obtained between three groups (p>0.05).Amaç: Romatoid Artrit (RA) kronik destrüktif inflamatuvar bir hastalıktır. Bu çalışma RA tanısıyla takip ettiğimiz hastalarda akuaterapi ve balneoterapinin etkilerini araştırmak amacıyla planlanmıştır. Gereç ve Yöntem: Çalışmaya Amerikan Romatizma Derneği (ACR) tanı kriterlerini dolduran ve RA tanısı konulan toplam 59 hasta dahil edildi. Hastalar randomize olarak üç gruba ayrıldılar. Grup 1 (n= 20) balneoterapi, grup 2 (n=20) akuaterapi, grup 3 (n=19) kontrol grubu olarak kabul edildi. Balneoterapi ve akuaterapi uygulamaları haftada beş gün, üç hafta süresince toplam 15 seans verildi. Hastalar klinik ve laboratuvar parametrelerce değerlendirildiler. Klinik değerlendirme; ağrı, sabah sertliği süresi, şiş ve hassas eklem sayısı, hastalık aktivite skorlaması (DAS28), Modifiye Sağlık Sorgulama Anketi (mHAQ), hastanın ve doktorun global değerlendirmesi ölçümünü içermektedir. Laboratuvar parametreler ise eritrosit sedimentasyon hızı (ESR), C-reaktif protein (CRP) olup tüm değerlendirme parametreleri tedavi öncesinde, tedavi sonrası (3. hafta) ve 3. ayda yapıldı. Bulgular: Hastaların yaş ortalamaları 54±10,7 (25-75) ve ortalama hastalık süreleri 122,3±98,1 (1-424) aydır. Akuaterapi grubunda ise DAS 28 skorlarında (p<0,001), hassas nokta sayısında (p<0.005), GAS skorlarında (p<0,005), mHAQ (p<0,05), hastanın ve doktorun global değerlendirim sonuçlarında istatistiksel an...

Improving the quality of life of patients with rheumatoid arthritis after rehabilitation irrespective of the level of disease activity

“…Our study shows that high disease activity is not a contraindication for rehabilitation due to the fact that those patients get a significant increase in quality of life and life condition. The need and effectiveness of rehabilitation is confirmed in many studies based on the decreasing pain level and disease activity index [20][21][22][23][24][25][26]. In the study of Sukharev et al [27], DAS28 level decreased after rehabilitation in all groups regardless of the rehabilitation program.…”

“…Studies revealed that exercises focused on improving muscle strength in patients with rheumatoid arthritis had statistically significant impact on achieved results even after 24 weeks [ 31 ]. The review of the literature on the subject as well as the present research indicate that the progress in patient rehabilitation is not affected by factors such as disease activity according to the DAS28 indicator or the rehabilitation program [ 24 , 25 , 27 ]. Rehabilitation based on various forms of physiotherapy or training programs gives different results, while all of them prove effective [ 24 ].…”

“…The review of the literature on the subject as well as the present research indicate that the progress in patient rehabilitation is not affected by factors such as disease activity according to the DAS28 indicator or the rehabilitation program [ 24 , 25 , 27 ]. Rehabilitation based on various forms of physiotherapy or training programs gives different results, while all of them prove effective [ 24 ]. To sum up, we may conclude that in the rehabilitation of RA patients, the key to success is the right choice of methods and forms of work with a specific patient.…”