Rheumatologic Rehabilitation
Journal
Braddom's Physical Medicine and Rehabilitation
ISBN
9780323625395
Date Issued
2020-01-01
Author(s)
Abstract
Rheumatology is a branch of medicine devoted to the evaluation, diagnosis, and management of musculoskeletal disorders or other connective diseases, including arthritis and sort tissue lesions. This chapter emphasizes diagnosis, evaluation, medical management, and rehabilitation of arthritis. For diagnosis of arthritis, a combination of history-taking and physical examination is the first step, followed by laboratory tests and image studies, if necessary. Evaluation of rheumatic disease may follow the model of the International Classification of Functioning, Disability and Health (ICF). The medical treatment of rheumatic disease includes analgesics, nonsteroidal antiinflammatory drugs (oral or topical use), corticosteroids (oral or local use), opioids, duloxetine, hyaluronic acid, hypertonic glucose, platelet-rich plasma, and disease-modifying antirheumatic drugs (DMARDs). Over the past two decades many DMARDs have been developed, including conventional synthetic, target synthetic, and biologic DMARDs, which can modify the disease course, although both minor and serious side effects exist. In patients with intractable pain, severe joint destruction, or poor response to long-term medical treatment and rehabilitation, surgery may be considered. Surgical techniques include total joint replacement, osteotomy, lavage and debridement, arthrodesis, tendon repair, and synovectomy. Among them, total joint replacement has been proven effective for different types of arthritis. In this chapter, common types of arthritis and rehabilitation interventions for arthritis, including exercise, physical modalities, orthoses, patient education, energy conservation techniques, and joint protection principles, are introduced, and the principles of rehabilitation for arthritis are reviewed, especially regarding osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.
Subjects
arthritis | occupational therapy | physical therapy | rehabilitation | rheumatology
Type
book part