Physical exercise and occupational therapy may enhance the quality of life in RA patients

A multidisciplinary strategy, comprising physical exercise therapy, occupational therapy, patient self-management, and pharmaceutical therapy, is necessary for the ideal care of rheumatoid arthritis (RA). According to a recent study published in Healthcare (Basel), the combination of occupational therapy and physical exercise improves the quality of life for rheumatoid arthritis (RA) patients. 

Cerasola and colleagues conducted the single-center trial study with PROBE design including 160 RA outpatients. These patients were further divided into two groups: an intervention group (IG), which engaged in exercises and joint protection movements at home to maintain muscle tone, and a control group (CG), consisting of 80 patients in each group. Patients in the IG exhibited higher cumulative illness rating scores for assessing severity and comorbidity index (2.81 vs. 2.58; 2.91 vs. 2.59, respectively), as well as greater morning stiffness (33.8 vs. 25.0), compared to CG patients. The disease activity score-28 (DAS28) using erythrocyte sedimentation rate (ESR), DAS28 using c-reactive protein (CRP), health assessment questionnaire (HAQ), and short-form health survey (SF-12) mental component scores all showed significant improvement following 30 days of joint economic intervention at home (P= 0.005, P = 0.004, P= 0.009, and P= 0.010, respectively). 

In a randomized controlled trial study conducted by Baldwin, 89 patients with both rheumatoid arthritis (RA) and osteoarthritis (OA) were included, along with a control group. The study’s findings indicated that for individuals dealing with RA and OA, an ergonomic workplace intervention led to a reduction in work-related arthritis problems over a span of 2 years. Moreover, improvements were observed in terms of physical functioning and pain when compared to the control group. Another study by Shao et al. reported that six months after the commencement of the intervention, a self-management program rooted in the self-efficacy theory, which emphasized joint protection and physical activity, yielded noteworthy enhancements in physical functioning, self-efficacy, and self-management behaviors. 

The current study highlights the significant role of patient education in the context of illness treatment. This was evident in the outcomes of a one-month self-management program that encompassed a comprehensive blend of educational elements, incorporating both occupational therapy and at-home physical activity. These findings suggest that a well-structured, one-month educational intervention conducted at home holds the potential to enhance the quality of life of RA patients. However, further research is required in order to generalize and corroborate the study findings. 

References 

  1. Cerasola D, Argano C, Chiovaro V, Trivic T, Scepanovic T, Drid P, et al. Physical Exercise and Occupational Therapy at Home to Improve the Quality of Life in Subjects Affected by Rheumatoid Arthritis: A Randomized Controlled Trial. Healthcare (Basel). 2023 Jul 25;11(15):2123. 
  2. Baldwin D, Johnstone B, Ge B, Hewett J, Smith M, Sharp G. Randomized prospective study of a work place ergonomic intervention for individuals with rheumatoid arthritis and osteoarthritis. Arthritis Care Res (Hoboken). 2012 Oct;64(10):1527–35.  
  3. Shao JH, Yu KH, Chen SH. Effectiveness of a self-management program for joint protection and physical activity in patients with rheumatoid arthritis: A randomized controlled trial. Int J Nurs Stud. 2021 Apr;116:103752.