Pasqui F, Mastrodonato L, Ceccarelli F, Scrivo R, Magrini L, Riccieri V, Di Franco M, Gentili M, Valesini G, Spadaro A
Cattedra di Reumatologia, Dip. di Clinica e Terapia Medica Applicata, Azienda Policlinico Umberto I, Università di Roma "La Sapienza", Roma, Italia.
Reumatismo. 2006 Jul-Sep;58(3):191-8. doi: 10.4081/reumatismo.2006.191.
To assess the effect of occupational therapy (OT) in rheumatoid arthritis (RA) patients treated with anti-TNF-alpha drugs in a short-term open controlled prospective study.
31 RA subjects [(M/F=5/26; mean age= 56 (range=28-73) years; mean disease duration= 165 (range =15-432) months], treated with anti- TNF-alpha drugs, were allocated to OT (n=15) or control (n=16) group. We evaluated at entry and 12 weeks the following outcome parameters including Health Assessment Questionnaire (HAQ), Short-Form Health Survey (SF-36), Global Health (GH), Ritchie index, number of swollen or tender joints, pain, patient and physician disease activity, Disease Activity Score (DAS28), erythrocyte sedimentation rate (ESR), C-reactive protein CRP) and the correct adherence to items regarding activity daily living (ADL).
At baseline, OT and control group had similar demographic and clinical features. After 12 weeks, the changes from baseline of main outcome parameters were not significantly different between the two groups. After 12 weeks, in 7 out of 11 items regarding ADL, the percentage of patients showing a correct adherence was significantly increased in OT group only. Moreover at the end of the study, the OT group showed a correct adherence to 8 out of 11 ADL items in an higher percentage of patients respect to the control group.
Our study sustains that OT improves self-management but not main parameters of disease activity or functional capacity. Nevertheless educational intervention should be considered as a useful tool in conjunction with pharmacological treatment.
在一项短期开放对照前瞻性研究中，评估职业治疗（OT）对接受抗TNF-α药物治疗的类风湿关节炎（RA）患者的疗效。
31名接受抗TNF-α药物治疗的RA受试者[男/女=5/26；平均年龄=56（范围=28-73）岁；平均病程=165（范围=15-432）个月]，被分配到OT组（n=15）或对照组（n=16）。我们在入组时和12周时评估了以下结局参数，包括健康评估问卷（HAQ）、简明健康调查（SF-36）、整体健康（GH）、里奇指数、肿胀或压痛关节数、疼痛、患者和医生的疾病活动度、疾病活动评分（DAS28）、红细胞沉降率（ESR）、C反应蛋白（CRP）以及对日常生活活动（ADL）项目的正确依从性。
在基线时，OT组和对照组具有相似的人口统计学和临床特征。12周后，两组主要结局参数相对于基线的变化无显著差异。12周后，在11项ADL项目中的7项中，仅OT组中显示正确依从性的患者百分比显著增加。此外，在研究结束时，相对于对照组，OT组中更高比例的患者对11项ADL项目中的8项显示出正确依从性。
我们的研究表明，OT可改善自我管理，但不能改善疾病活动度或功能能力的主要参数。然而，教育干预应被视为与药物治疗相结合的一种有用工具。
