Perrotta Fabio Massimo, Scriffignano Silvia, Benfaremo Devis, Ronga Mario, Luchetti Michele Maria, Lubrano Ennio
Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy.
Clinica Medica, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy.
Rheumatol Ther. 2021 Jun;8(2):639-649. doi: 10.1007/s40744-021-00298-9. Epub 2021 Mar 12.
Psoriatic arthritis (PsA) is a complex, multiform and chronic inflammatory disease characterized by the association of psoriasis and arthritis with other musculoskeletal and extra-articular manifestations. The treatment of PsA is rapidly evolving due to the introduction of new biologic and small-molecule drugs, and the aim of treatment is to induce a condition of remission or low disease activity in all disease domains. However, unmet treatment needs still persist for those patients with impaired function, reduced quality of life or comorbidities. In this context, physical therapy and rehabilitation could provide additional benefits by reducing disease activity and improving function. Although a large number of studies have assessed the role of physical therapy and exercise in other forms of chronic inflammatory arthritis, such as axial spondyloarthritis and rheumatoid arthritis, evidence on their effect on persons with PsA is still lacking. However, some studies have reported the potential positive role of physical therapy on the different disease domains of PsA, in helping to improve disease activity, prevent or improve articular impairment, improve pain management and improve quality of life. Here, we review current evidence on physical therapy, exercise and rehabilitation in patients with PsA. In particular, we review the literature focusing on each domain, to provide evidence of efficacy and effectiveness of exercise and rehabilitation on skin, peripheral arthritis, axial involvement, dactylitis, enthesitis and comorbidities.
银屑病关节炎（PsA）是一种复杂、多形的慢性炎症性疾病，其特征为银屑病、关节炎与其他肌肉骨骼及关节外表现相关联。由于新型生物制剂和小分子药物的引入，PsA的治疗正在迅速发展，治疗目标是在所有疾病领域诱导缓解或低疾病活动状态。然而，对于那些功能受损、生活质量下降或患有合并症的患者，尚未满足的治疗需求仍然存在。在此背景下，物理治疗和康复可通过降低疾病活动度和改善功能带来额外益处。尽管大量研究评估了物理治疗和运动在其他形式慢性炎症性关节炎（如轴性脊柱关节炎和类风湿关节炎）中的作用，但关于其对PsA患者影响的证据仍然缺乏。然而，一些研究报告了物理治疗在PsA不同疾病领域的潜在积极作用，有助于改善疾病活动度、预防或改善关节损伤、改善疼痛管理及提高生活质量。在此，我们综述了目前关于PsA患者物理治疗、运动和康复的证据。特别是，我们回顾了聚焦于每个领域的文献，以提供运动和康复在皮肤、外周关节炎、轴向受累、指（趾）炎、附着点炎及合并症方面的疗效和有效性证据。
