REHABILITATION OF RHEUMATOID ARTHRITIS
Rheumatoid arthritis (RA) is a chronic inflammatory disease that mainly affects the joints. The goal of RA treatment is to achieve low disease activation, functional recovery, and prevention of structural damage. When planning drug treatment in RA, disease activity, factors affecting the course of the disease, the presence of additional diseases and safety should be taken into consideration.
Using methotrexate (MTX) alone or in combination with other disease-modifying drugs as drug therapy is the first step. is the treatment. If MTX is contraindicated, sulfosalazine or leflunamide can be used. If there is no response to these treatments, biological medications may need to be started.
General principles in rehabilitation are patient education, maintaining or improving functional status, preventing disability and increasing the quality of life.
High disease activity in RA. As a result of inactivity and changes in muscle metabolism, muscle weakness and loss of muscle mass are observed. The aim of the exercise program is to maintain or increase joint range of motion, increase muscle strength and endurance, increase joint function and increase aerobic capacity.
In patients with RA, reducing pain and swelling and preventing deformities by keeping the joint in a functional position with a splint or orthosis. It is aimed to eliminate or eliminate.
Assistive devices used to continue daily life activities help to increase the patient's functional level, reduce the load on the joints and help the patient achieve an independent position in society.
Pain in the joints and Cold application is preferred to reduce swelling. Heat application can reduce muscle tension and pain in patients whose systemic disease activity is controlled. TENS therapy for pain may be effective. Electrical stimulation can be effective in reducing hand muscle wasting, increasing hand grip strength and improving functions. Low-power laser treatment can be used to reduce pain and morning stiffness.
ANKYLOSING SPONDYLITIS REHABILITATION
Ankylosing spondylitis (AS) characteristically involves the spine, causing advanced structural damage. What causes functional loss and decreased quality of life? It is a chronic disease that can occur from
The first-line treatment for AS is the initiation of non-steroidal anti-inflammatory drugs.
Physiotherapy and rehabilitation have a great place and importance in the non-drug treatment of AS. General goals in AS rehabilitation; to reduce pain, increase muscle strength and endurance, increase balance and physical condition, and minimize joint deformities.
Patients should be informed about the disease, especially in the early period, maintain appropriate posture, sleep on a low pillow and appropriate bed, stay forward for long periods of time. They should be trained not to work by bending over and to do regular daily exercise.
Apart from daily exercises, swimming positively affects aerobic capacity and lung functions. Sportive activities increase functional capacity, maintain joint range of motion, and increase muscle endurance.
Care should be taken against excessive pain and injuries in stretching and endurance exercises, especially in cases of inflammation at tendon attachment sites, considering the sensitivity of the joint environment and joint capsule tension. .
Hot therapy and electrotherapy can be applied before exercise treatment to increase tolerance and reduce symptoms.
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