Department of Rheumatology, Section for Climate Therapy, Oslo University Hospital, Oslo, Norway.
J Rehabil Med. 2010 Nov;42(10):897-902. doi: 10.2340/16501977-0632.
To present the evidence for the efficacy of comprehensive rehabilitation in a warm climate of patients with a wide variety of rheumatic diseases.
A systematic review of the literature was undertaken, searching in PubMed, Cinahl, Pedro, SweMed and Embase from 1970 to 2010, and using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation system) criteria.
Six studies met the inclusion criteria. For patients with rheumatoid arthritis, moderate evidence was found for reduction of disease activity, pain, fatigue, and global disease impact. The evidence was also moderate that comprehensive rehabilitation in a warm climate did not improve fitness or reduce activity limitation beyond levels reached by rehabilitation in Scandinavia. Among patients with ankylosing spondylitis, low evidence was found for reduction of disease activity, pain, joint range of motion, activity limitation, and global disease impact. In groups with mixed rheumatic diagnoses, low evidence was found for reduction of pain, activity limitation, global disease impact and improved health-related quality of life. No studies on psoriatic arthritis, osteoarthritis, fibromyalgia or osteoporosis were found.
Well-designed studies to validate and improve the low-to-moderate evidence found for the efficacy of comprehensive rehabilitation in a warm climate among patients with inflammatory rheumatic disease are greatly needed.
展示在温暖气候下对各种风湿性疾病患者进行综合康复治疗的疗效证据。
系统检索了 1970 年至 2010 年在 PubMed、Cinahl、Pedro、SweMed 和 Embase 上的文献，并使用 GRADE（推荐分级、评估、发展与评价系统）标准进行评估。
有 6 项研究符合纳入标准。对于类风湿关节炎患者，有中度证据表明综合康复治疗在温暖气候下可降低疾病活动度、疼痛、疲劳和整体疾病影响。也有中度证据表明，综合康复治疗在温暖气候下并不能提高健康相关体能或降低活动受限程度，超过在斯堪的纳维亚进行康复治疗所达到的水平。对于强直性脊柱炎患者，有低度证据表明综合康复治疗可降低疾病活动度、疼痛、关节活动度、活动受限和整体疾病影响。在混合风湿性疾病组中，有低度证据表明疼痛、活动受限、整体疾病影响和健康相关生活质量得到改善。未发现关于银屑病关节炎、骨关节炎、纤维肌痛或骨质疏松症的研究。
非常需要设计良好的研究来验证和提高在温暖气候下对炎症性风湿性疾病患者进行综合康复治疗的疗效的低至中度证据。
