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Vol. 7. Issue 4.
Pages 224-229 (July - August 2011)
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Vol. 7. Issue 4.
Pages 224-229 (July - August 2011)
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Influence of the physical therapy on the health and quality of life of the rheumatic patient
Influencia de la fisioterapia sobre el estado de salud y la calidad de vida del paciente reumático
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Elena Penelope De Dios Sanchoa, Ana M. Martin-Noguerasa,b,
Corresponding author
anamar@usal.es

Corresponding author.
a Área de Fisioterapia, Departamento de Física, Ingeniería y Radiología Médica, Universidad de Salamanca, Salamanca, Spain
b Escuela Universitaria de Enfermería y Fisioterapia, Salamanca, Spain
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Abstract
Objective

To evaluate the effectiveness of a specific physical therapy treatment on stiffness, pain and quality of life (HRQL) in rheumatic patients.

Methods

Experimental, prospective, longitudinal and intervention study. It involved 29 individuals with a mean age (SD) of 54.16 (11.9) years, belonging to the Salmantina Association of Rheumatoid Arthritis Patients, randomized into 2 groups: treatment (GT) and control (GC). The study analyzed the time in minutes of morning stiffness, pain -using the Downie Scale- and CVRS through the Nottingham Health Profile (NHP) and the Health Questionnaire SF-36 (SF-36). It carries out an individual treatment that includes mainly physiotherapy manual techniques in one or two sessions per week for six months.

Results

The time of early morning stiffness showed a mean (SD) 21.38 (29.99) minutes (GC=20.38, GT=22.19), increasing in GC (26.82) and decreasing in GT (12.5). Pain presented at the beginning a mean (SD) 3.6 (2.03) points (GC=2.85, GT=4.22) decreasing in GT (3.68) and increasing in GC (3.45). There was an improvement of CVRS in the GT with decreased scores on four dimensions of NHP (pain, sleep, physical mobility and emotional reactions) and increases in SF-36 (physical problems, social function, pain, function physics). In any case the results were statistically significant.

Conclusion

The study cannot conclude the effectiveness of physiotherapy in the treatment of rheumatoid arthritis although the results show a decrease of morning stiffness and pain and increased CVRS, which is clinically interesting.

Keywords:
Rheumatoid arthritis
Physical therapy
Pain
Quality of life
Resumen
Objetivos

Evaluar la eficacia de un tratamiento de fisioterapia sobre rigidez, dolor y calidad de vida relacionada con la salud (CVRS) en pacientes reumáticos.

Material y método

Estudio experimental, prospectivo, longitudinal y de intervención. Participan 29 sujetos con edad media (SD) de 54,16 (11,9) años, pertenecientes a la Asociación Salmantina de Pacientes con Artritis Reumatoide distribuidos aleatoriamente en 2 grupos: tratamiento (GT) y control (GC). Se valora la rigidez matinal en minutos, el dolor mediante la Escala de Downie y la CVRS a través del Perfil de Salud de Nottingham (NHP) y el Cuestionario de Salud short form-36 (SF-36). Se lleva a cabo un tratamiento individual de fisioterapia que incluye principalmente técnicas manuales en una o 2 sesiones semanales durante 6 meses.

Resultados

La rigidez matinal presentó al inicio una media (SD) de 21,38 (29,99) min (GC=20,38, GT=22,19), aumentando en GC (26,82) y disminuyendo en GT (12,5). El dolor presentó al inicio media (SD) de 3,6 (2,03) puntos (GC=2,85, GT=4,22) disminuyendo en GT (3,68) y aumentando en GC (3,45).

Se registró una mejora de CVRS en el GT con disminución de las puntuaciones en 4 dimensiones del NHP (dolor, sueño, movilidad física y reacciones emocionales) y aumento en el SF-36 (problemas físicos, función social, dolor, función física). En ningún caso los resultados fueron estadísticamente significativos.

Conclusión

El estudio no puede concluir la eficacia de la fisioterapia en el tratamiento de la artritis reumatoide aunque los resultados apuntan a una disminución de la rigidez matinal y del dolor y un aumento de la CVRS, clínicamente interesantes.

Palabras clave:
Artritis reumatoide
Fisioterapia
Dolor
Calidad de vida
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References
[1.]
J.V. Moreno.
Memoria de medio siglo de actividad a favor del paciente reumático.
Los Reumatismos, 4 (2006), pp. 12-13
[2.]
L. Carmona, R. Gabriel, F.J. Ballina, A. Laffon, Grupo de Estudio EPISER.
P royecto EPISER 2. 000: Prevalencia de enfermedades reumáticas en la población española. Metodología, resultados del reclutamiento y características de la población.
Rev Esp Reumatol, 28 (2001), pp. 18-25
[3.]
M.D. Ruiz-Montesinosa, B. Hernández-Cruza, R. Ariza-Ariza, L. Carmona, J. Ballinac, F. Navarro-Sarabiaa, et al.
Análisis de costes en una cohorte de enfermos con artritis reumatoide atendidos en un área especializada de reumatología en España.
Reumatol Clin, 1 (2005), pp. 193-199
[4.]
Fl. Mahoney, D.W. Bartheñ.
Funcional evaluation: the Barthel Index.
Md State Med, 14 (1965), pp. 61-65
[5.]
J. Cid- Ruzafa, J. Damián-Moreno.
Valoración de la discapacidad física: el Índice de Barthel.
Rev Esp Salud Publica, 71 (1997), pp. 127-137
[6.]
M.P. Lawton, E.M. Brody.
Assessment of older people: self-maintaining and instrumental activities of daily living.
Gerontologist, 9 (1969), pp. 179-186
[7.]
Wn. Downie, P.A. Leatham, V.M. Rhind.
Studies with pain rating scales.
Ann Rheum Dis, 37 (1979), pp. 378-381
[8.]
J. Alonso, J.M. Anto, C. Moreno.
Spanish version of the Nottingham Health Profile: translation and preliminary validity.
Am J Public Health, 80 (1990), pp. 704-708
[9.]
L. Prieto, J. Alonso, M.C. Viladrich, J.M. Anto.
Scaling the Spanish version of the Nottingham Health Profile: evidence of limited value of item weight.
J Clin Epidemiol, 49 (1996), pp. 31-38
[10.]
J. Alonso, L. Prieto, J.M. Anto.
La versión española del SF-36. Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos.
Med Clin, 104 (1995), pp. 771-776
[11.]
D.G. Scott, E.M. Barrett, P. Merry, E. Arie, K. Gaffney, A.J. Silman, et al.
Benchmarking: the five year outcome of rheumatoid arthritis assessed using a pain score, the Health Assessment Questionnaire, and the Short Form-36 (SF-36) in a community and a clinic based sample.
Ann Rheum Dis, 60 (2001), pp. 956-961
[12.]
F.C. Arnett, D.A. Bloch, D.Mc. Shane.
The ARA 1987 revised criteria for the classification of the rheumatoid arthritis.
Arthritis Rheum, 31 (1988), pp. 315-324
[13.]
K. Hakakamoh, R. Pollanen, P. Nienimen.
The ARA 1987 revised criteria select patients with clinical rheumatoid artritis from a population based cohort of subjets with chronic rheumatic disease registered for drug reimbursement.
J Rheumatol, 20 (1993), pp. 1674-1678
[14.]
N. Gómez.
Repercusión socioeconómica de la artritis reumatoide.
An Med Interna, 20 (2003), pp. 111-113
[15.]
B. Harrison, D. Symmons.
Early inflammatory polyarthritis: results from the Norfolk Arthritis Register with a review of the literature. II. Outcome at three years.
Rheumatology, 39 (2000), pp. 939-949
[16.]
J. Talamo, A. Frater, S. Gallivans, A. Young.
Use of the short form 36 (SF36) for health status measurement in rheumatoid arthritis.
Br J Rheumatol, 36 (1997), pp. 463-469
[17.]
D.A. Ruta, N.P. Hurst, P. Kind, M. Hunter, A. Stubbings.
Measuring health status in british patients with rheumatoid arthritis: reliability, validity and responsiveness of the short form 36 item health survey (SF-36).
Br J Rheumatol, 37 (1998), pp. 425-436
[18.]
T. Uutela, M. Hakala, H. Kautiainen.
Validity of the Nottingham Health Profile in a Finnish out-patient population with rheumatoid arthritis.
Rheumatology, 42 (2003), pp. 841-845
[19.]
T. Uutela, M. Hakala, H. Kautiainenen.
Nottingham Health Profile Questionnaire incorporates important aspects of the patient perspective into outcome assessment in rheumatoid arthritis.
Clin Exp Rheumatol, 26 (2008), pp. 39-44
[20.]
F.G. Oosterverl, J.J. Rasker.
Effects of local heat and cold treatment on surface and articular temperature of arthritis knees.
Arthritis Rheum, 37 (1994), pp. 1578-1582
[21.]
K.A. Sluka, M.R. Christy, W.L. Peterson, S.L. Rudd, S.M. Troy.
Reduction of pain-related behaviors with either cold or heat treatment in an animal model of acute arthritis.
Arch Phys Med Rehabil, 80 (1999), pp. 313-317
[22.]
M. Ivey, R.V. Johnston, T. Ulchida.
Cryotherapy for postoperative pain relief following knee arthroplasty.
J Arthroplasty, 9 (1994), pp. 285-290
[23.]
N. Schlesinger, M.A. Detry, B.K. Holland, D.G. Baker, A.M. Beutler, M. Rull, et al.
Local ice therapy during bouts of acute gouty arthritis.
J Rheumatol, 29 (2002), pp. 331-334
[24.]
D. Mustur, N. Vujasinovic-Stupar, T. Ille.
Influence of physical treatment on disease activity and health status of patients with chronic arthritis.
Srp Arh Celok Lek, 136 (2008), pp. 104-109
[25.]
S. Stojanovic, A. Dimic, B. Stamenkovic, A. Stankovic, J. Nedovic.
Influence of balneophysical therapy on activity, functional capacity and quality of life in patients with rheumatoid arthritis.
Srp Arh Celok Lek, 137 (2009), pp. 171-174
[26.]
G.C. Goats, J.A. Hunter, E. Flett, A. Stirling.
Low intensity laser and phototherapy for rheumatoid arthritis.
Physiotherapy, 82 (1996), pp. 311-320
[27.]
K. Konrad.
Randomized, double-blind, placebo-controlled study of ultrasonic treatment of the hands of rheumatoid arthritis patients.
Eur J Phys Rehabil Med, 4 (1994), pp. 155-157
[28.]
A.I. Perlman, A. Sabina, A.L. Williams, V.Y. Njike.
Massage therapy for osteoarthritis of the knee.
Arch Intern Med, 166 (2006), pp. 11-25
[29.]
M.S. Medlicott, S.R. Harris.
A systematic review of the effectiveness of exercise manual therapy, electrotherapy, relaxation training and biofeedback in the management of temporomandibular disorder.
Phys Ther, 86 (2006), pp. 955-973
Copyright © 2011. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
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