Buljina A I, Taljanovic M S, Avdic D M, Hunter T B
Department of Physical Medicine and Rehabilitation, Clinical Center of the University of Sarajevo, Bosnia and Herzegovina.
Arthritis Rheum. 2001 Aug;45(4):392-7. doi: 10.1002/1529-0131(200108)45:4<392::AID-ART353>3.0.CO;2-2.
To study the short-term effects of physical therapy (ice massage or wax packs, thermal baths, and faradic hand baths) and exercise therapy on the rheumatoid hand.
The effect of individual physical therapy and exercise therapy programs was evaluated in 50 randomly selected rheumatoid arthritis inpatients (38 women and 12 men). Mean patient age (+/- SD) was 47.94 +/- 11.22 years, and mean disease duration was 5.04 +/- 4.80 years. The control group consisted of 50 randomly selected rheumatoid arthritis outpatients (37 women and 13 men; mean age 48.46 +/- 10.65 years, mean duration of disease 5.23 +/- 4.89 years) who at the time of the investigation were not receiving any physical or exercise therapy. The clinical indices used for evaluation of inflammation included erythrocyte sedimentation rate (ESR), pain intensity, proximal interphalangeal (PIP) joint size, and Ritchie articular index. Hand grip strength, palmar tip-to-tip and key pinch finger strength, finger range of motion, and activities of daily living (ADL) were the parameters used to assess the functional hand status. The study was single-blinded and of 3 weeks duration.
In the physical therapy treated group, there was an improvement for most of the observed indices from baseline parameters that achieved statistical significance (P < 0.01 and P < 0.005) after the 3-week study period. ESR and PIP joint size improved clinically but failed to reach statistical significance. Patients had a more significant improvement in hand pain, joint tenderness, and ADL score (P < 0.005) than in range of motion (P < 0.01). All parameters in the control group slightly deteriorated over the study period.
At least in the short term, physical and, particularly, exercise therapy produce a favorable improvement in the functional status of the rheumatoid hand.
研究物理治疗（冰敷按摩或蜡疗、热水浴和感应电手部浴）及运动疗法对类风湿性手部疾病的短期疗效。
对50例随机选取的类风湿性关节炎住院患者（38例女性，12例男性）的个体物理治疗和运动治疗方案的效果进行评估。患者平均年龄（±标准差）为47.94±11.22岁，平均病程为5.04±4.80年。对照组由50例随机选取的类风湿性关节炎门诊患者（37例女性，13例男性；平均年龄48.余岁）组成。余岁，平均病程5.23±4.89年）组成，这些患者在调查时未接受任何物理或运动治疗。用于评估炎症的临床指标包括红细胞沉降率（ESR）、疼痛强度、近端指间（PIP）关节大小和里奇关节指数。握力、手掌指尖对指尖和关键捏指力、手指活动范围以及日常生活活动（ADL）是用于评估手部功能状态的参数。该研究为单盲研究，为期3周。
在接受物理治疗的组中，经过3周的研究期后，大多数观察指标相对于基线参数有所改善，且具有统计学意义（P<0.01和P<0.005）。ESR和PIP关节大小在临床上有所改善，但未达到统计学意义。患者手部疼痛、关节压痛和ADL评分的改善比活动范围的改善更显著（P<0.005）（P<0.01）。在研究期间，对照组的所有参数均略有恶化。
至少在短期内，物理治疗，尤其是运动疗法能使类风湿性手部的功能状态得到良好改善。
