Bone Abstracts

Introduction: The evidence for the effectiveness of early rehabilitation of patients with rheumatoid arthritis (RA) is scanty. The aim of the study is to evaluate the efficiency of rehabilitation program for patients with early RA.

Methods: 34 study group patients with early RA underwent 6-month rehabilitation (hospital stage: 15-min local air cryotherapy (−;60 °C, Criojet Air C600) for hand, knee or ankle joints, 45-min therapeutic exercises under the supervision of a trainer, 45-min occupational therapy (joint protection strategies, use of assistive devices), ten sessions, education program (four daily 90-min studies) and outpatient stage: 45-min exercises three times a week, functional wrist and knee orthoses, customized foot insoles). Twenty-six patients received only drug therapy (control). Tender and swollen joint count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), joint pain on 100-mm VAS, DAS28, HAQ, RAPID3, hand grip strength, the average powers of knee extension and ankle flexion by the EN-TreeM movement analysis were evaluated.

Results: 22 patients finished the rehabilitation program. After 6-month rehabilitation, tender joint count decreased by 72.3% (6.0±1.8, P<0.01), swollen – by 74.1% (4.0±1.2, P<0.01), ESR – by 58.2% (P<0.01), CRP – by 67.2% (P<0.01), pain – by 70.4% (P<0.01), DAS28 – by 31.9% (1.38±0.2, P<0.05), HAQ – by 75.8% (0.97±0.56, P<0.01), RAPID3 – by 60.1% (5.98±0.92, P<0.01). The grip strength of a more affected hand enhanced by 44.9%, of a less affected – by 31.3% (P<0.05). The average extension power of a weaker knee increased by 88.7%, of a stronger – by 67.7% (P<0.01). The average flexion power of a more affected ankle joint elevated by 81.6%, of a less affected – by 70.2% (P<0.01). The changes in the control group were less pronounced, which determined statistically significant differences between the groups in most indicators.

Conclusion: The rehabilitation program reduces diseases activity, improves functional ability, motion activity, quality of life in patients with early RA.