Department of Rheumatology, Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany.
Department of Medical Statistics, University Medical Center Göttingen, Germany.
Clin Exp Rheumatol. 2022 Jul;40(7):1343-1351. doi: 10.55563/clinexprheumatol/lmbdlm. Epub 2021 Sep 28.
To prospectively evaluate the effects of multimodal rheumatologic complex treatment (MRCT), a special concept of in-patient physical treatment (PT), in patients with rheumatoid arthritis (RA).
RA patients receiving a 16-day MRCT were eligible. MRCT was delivered to participants in 64 PT sessions of various modalities with a minimum of 1.400 Minutes of treatment. The primary outcome was the change in pain levels measured on a numeric rating scale (0-10) between baseline and discharge. Secondary outcomes were assessments of i) disease activity, ii) functional disabilities, iii) serum cytokine levels, iv) analgesic usage, v) patient global health and vi) patient's satisfaction with their therapeutic response to MRCT from baseline to discharge and over a 12-week follow-up.
53 RA patients completed the study and were analysed. Pain levels were reduced significantly and clinically meaningfully (mean ± standard error: -2.1 ± 0.3, p<0.001). Effects of MRCT lasted up to 12 weeks after discharge. After MRCT and during the 12-week follow-up use of analgesics was reduced compared to baseline. Regression analyses revealed no influencing factors on change in pain levels. Patient global health assessment remained improved throughout the entire follow-up period. No MRCT-related side effects were recorded.
MRCT as a multimodal treatment concept with a strong emphasis on PT reduces pain significantly and in a clinically meaningful manner allowing for reduced analgesic usage.
前瞻性评估多模式风湿病综合治疗（MRCT）对类风湿关节炎（RA）患者的影响。
接受 16 天 MRCT 的 RA 患者符合条件。MRCT 以 64 次不同方式的物理治疗（PT）疗程提供给参与者，每次疗程的治疗时间不少于 1400 分钟。主要结局是从基线到出院时用数字评分量表（0-10）测量的疼痛水平变化。次要结局是评估 i）疾病活动度，ii）功能障碍，iii）血清细胞因子水平，iv）镇痛药物使用，v）患者整体健康状况和 vi）患者对 MRCT 治疗反应的满意度，从基线到出院以及 12 周随访。
53 例 RA 患者完成了研究并进行了分析。疼痛水平显著降低，且具有临床意义（平均值 ± 标准误差：-2.1 ± 0.3，p<0.001）。MRCT 的效果持续到出院后 12 周。MRCT 后和 12 周随访期间，与基线相比，镇痛药的使用减少。回归分析显示，疼痛水平变化没有影响因素。患者整体健康评估在整个随访期间保持改善。未记录到与 MRCT 相关的副作用。
MRCT 作为一种多模式治疗概念，特别强调物理治疗，可显著减轻疼痛，且具有临床意义，从而减少镇痛药物的使用。
