The impact of health resort treatment on improvement of upper limb function in patients with rheumatoid arthritis

Bożena Ostrowska, Edyta Szczuka, Marta Walkowiak, Beata Skolimowska

Bożena Ostrowska, Edyta Szczuka, Marta Walkowiak, Beata Skolimowska – The impact of health resort treatment on improvement of upper limb function in patients with rheumatoid arthritis. Fizjoterapia Polska 2004; 4(3); 194-202

Abstract

Background. The frequency of upper limb dysfunction in rheumatoid arthritis and the disability associated with progressive deformation make it necessary to search for treatment solutions. Treatment in a health resort makes comprehensive physiotherapy available to patients, including kinesitherapy, physiotherapy, massages, diet, and climatic treatment. The aim of our study was to estimate the effectiveness of health resort treatment in producing functional improvement of the upper limbs in patients with rheumatoid arthritis. Material and methods. 23 women and 7 men, age 25-65, took part in a comprehensive physiotherapy program in Świeradów-Zdrój, a Polish health resort. Range of movement in the joints was evaluated by goniometry; Lovett’s test was used to measure muscle strength; joint and muscular circumferences were measured; manual efficiency was tested; and the subjects completed a pain questionnaire. All measurements were taken before and after treatment. Results. Improved movement in all upper limb joints was confirmed, especially in flexion and abduction in the shoulder joint (p < 0.001). Moreover, decreased swelling was observed in the elbow and carpal joints (p < 0,001), as well as greater manual dexterity in terms of precision, speed and strength of grip. Insignificant improvement was noted in muscle strength, especially in the extensor muscles of wrist and elbow. No increase in muscle mass was observed. Conclusions. Pain intensity was lower after treatment. Three weeks treatment in a health resort with comprehensive physiotherapy seems to be long enough for significant improvement of upper limb function in patients suffering from rheumatoid arthritis.

Key words:
kinesitherapy, therapeutic massage, therapeutic diet, climatotherapy
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Acceptance of illness in patients with rheumatoid arthritis

Rafał Szafraniec, Edyta Szczuka, Anna Pawłowska

Rafał Szafraniec, Edyta Szczuka, Anna Pawłowska – Acceptance of illness in patients with rheumatoid arthritis. Fizjoterapia Polska 2012; 12(1); 39-48

Abstract
The aim of the study was to assess the degree of acceptance of illness (AI) by persons affected by rheumatoid arthritis as related to the disease duration and selected socio-demographic factors. The research group consisted of 22 women and 18 men (average subjects” age was 50.7±14.3 years, and average disease duration – 14.4±7.8 years). In the study Acceptance of Illness Scale (AIS) was used. Men were found to have slightly higher levels of AI (29.06) than women (24.32). AI ratio was the lowest among those who lost their spouse (17.71), the unmarried 23.5, the married 29.84 (p<0.001). The respondents with university degrees, obtained the average AI value of 32.5; the scores obtained from the subjects with secondary; vocational and basic education were 23, 21.86 and 26.64 respectively (p<0.02). The patients with RA aged below 39 years obtained the average AI value of 31.55, those aged from 40-59 years – 27.94, and those over 60 years – 19.67 (p<0.01). Negative correlation was observed between the duration of the disease and its degree of acceptance (r =-0.64, p<0.00001). The long duration of illness has a negative impact on the degree of disease tolerance. Younger, better educated and having their spouse’s support patients find it easier to adapt to functional limitations caused by rheumatoid arthritis. Both gender and place of residence (city or village) does not significantly influence the level of acceptance of the disease in patients with RA.
Key words:
rheumatoid arthritis (RA), acceptance of illness (AI)
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