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[风湿性疾病的循证物理治疗]

[Evidence-based physical therapy of rheumatic diseases].

作者信息

Mau Wilfried

出版信息

Dtsch Med Wochenschr. 2016 Sep;141(20):1470-1472. doi: 10.1055/s-0042-112097. Epub 2016 Oct 4.

Abstract

New studies increase the evidence, that different applications of physical therapy are effective. In patients with rheumatoid arthritis (RA) physiotherapy of the hands improve strength, joint mobility and activity without increased risk of pain nor inflammation. A theory-based physiotherapy of the hands shows clinical effectiveness and cost-utility. In patients with spondyloarthritides supervised group exercise training is more effective than home exercise programs. Compared with biologics only combined exercise training and tumour necrosis factor alpha inhibitor therapy improve mobility and disease activity more effectively. Aerobic exercise training reduces fatigue in RA. Working wrist splints and static resting splints improve pain and grip strength. Static resting splints reduce the risk of hand deformities. Local and whole body cryotherapy show short term improvement of pain and inflammatory activity. German S3-guidelines recommend enhanced utilisation of physical therapy as well as coordinated multiprofessional team care and rehabilitation.

摘要

新的研究增加了证据,表明物理治疗的不同应用是有效的。在类风湿性关节炎(RA)患者中,手部物理治疗可提高力量、关节活动度和活动能力,且不会增加疼痛或炎症的风险。基于理论的手部物理治疗显示出临床有效性和成本效益。在脊柱关节炎患者中,监督下的团体运动训练比家庭运动计划更有效。与仅使用生物制剂相比,联合运动训练和肿瘤坏死因子α抑制剂治疗能更有效地改善活动能力和疾病活动度。有氧运动训练可减轻类风湿性关节炎患者的疲劳。工作用手腕夹板和静态休息夹板可改善疼痛和握力。静态休息夹板可降低手部畸形的风险。局部和全身冷冻疗法可在短期内改善疼痛和炎症活动。德国S3指南建议加强物理治疗的应用以及协调多专业团队护理和康复。

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