Improved medical treatment of rheumatic diseases prevents major functional limitations for many patients. However, adjusting to living with a chronic rheumatic disease may still be a complex and demanding process involving behavioral, cognitive and emotional aspects. From the early onset of the illness, multidisciplinary rehabilitation is a valuable adjunct to medical treatment in this process. Multidisciplinary rehabilitation in the context of a biopsychosocial model of illness has been shown to be beneficial for patients with rheumatic diseases. However, research also shows that rehabilitation outcomes tend to be short-lived. After 6–12 months, most patients are back to their initial health status.
This draws attention to the nature of rehabilitation outcomes and to factors and interventions that may help to increase the duration of positive outcomes.
Rehabilitation in rheumatology:
In the twenty-first century, the public health perspective of promoting physical activity for improving the quality of life, function, and participation of patients is embraced.
The research focus is on investigating the impact of weight
Total/Local body rest. Bed rest is practical but should not be applied for more than four days especially in the elderly.
Massage Rehabilitation modalities in rheumatology
Range of motion (ROM) and flexibility exercises
Help preserve joint movements and are passive when performed by the physiotherapist or active when there’s patient involvement.
Isometric /static exercises: Muscle contractions here are achieved without joint movement and lengthening or shortening of muscle fibers; they can be generated with the help of a fixed object like the hand of the therapist, a belt, small ball or elastic band. Isometric exercises increase strength and resistance and are easy and safe to be performed by patients with inflammatory arthritis.
Isotonic /dynamic exercises–involve changes in the muscle fiber length through their lengthening (eccentric) or shortening (concentric); nearby joints move through full ROM.
Aerobic conditioning/strengthening exercises: moderate-intensity exercises are effective (70-80% max heart rate) and include walking, running, cycling, swimming and stair climbing.
Bearing activities of various intensities on joint integrity in light of radiological advancements and the advent of modern biologic therapies.
JUVENILE IDIOPATHIC ARTHRITIS
Juvenile idiopathic arthritis (JIA) is inflammation (swelling) of one or more of your joints. It first occurs before your 16th birthday. JIA is slightly more common in girls. It most commonly occurs in pre-school age children or teenagers.
It occurs when the protective cartilage that cushions the ends of your bones wears down over time. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine.
It is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body.
Gout is a common and complex form of arthritis that can affect anyone. It's characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.
Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders. Signs and symptoms of polymyalgia rheumatica usually begin quickly and are worse in the morning.