Issue: 2017, Vol. 22, No. 2
FUNCTIONAL STATUS DYNAMICS IN PATIENTS WITH RHEUMATOID ARTHRITIS ON THE BACKGROUND OF THERAPEUTIC REHABILITATIVE MEASURES IN DISPENSARY
- Keywords
- rheumatoid arthritis, sarcopenia, functional status, rehabilitation
- Abstarct
- Objective - to evaluate the efficacy of therapeutic rehabilitative measures in patients with rheumatoid arthritis in dispensary which include the correction of the basic disease activity and functional disorders which are connected with sarcopenia and risk for fall. Material and methods . 86 women with trustworthy rheumatoid arthritis (average age - 59 ± 7,52 years, average duration of rheumatoid arthritis - 8,49 ± 7,52 years) were examined. Body composition and osseous tissue mineral density were evaluated. The diagnosis of sarcopenia included the measurement of muscle force by hand dynamometer, the performing of tests for physical activity estimation and the evaluation of skeletal muscles by emaciated mass index. Results . Hand force decrease was observed in 97,7% women, balance disturbance - in 70,9(%, heightened risk for fall - in 72,1%, low walking speed - in 18,6. Sarcopenia was revealed in 14,0% patients. The repeated examination was performed in three years follow-up. The activity of the disease was trustworthy decreased (by DAS28 index), the progression of roentgenologic alterations was marked (growth of the number of patients with IV roentgenologic stage). On the background of rehabilitative measures which included remedial gymnastics, physiotherapy, treatment and prevention of osteoporosis the improvement of functional abilities was marked (the number of patients with I functional class increased owing to the decrease of the number of patients with II-III functional classes). The number of patients who could not walk 100 m without stop and to get up from the chair without support of hands was decreased. Densitometry with body composition determination was performed repeatedly in 12 patients including 3 patients with initial sarcopenia. Sarcopenia in dynamics was retained in only one patient and new cases of sarcopenia were not detected. There were no trustworthy changes in the parameters of mineral density of osseous tissue. Conclusions . Therapeutic rehabilitative complex which includes monitoring of rheumatoid arthritis activity, treatment and prevention of osteoporosis, remedial gymnastics and physiotherapeuitic procedures in systematic observation and treatment corrected by the rheumatologist within 3 years allowed to improve functional status of the patients.
Мясоедова