Bhagwatkar Sawari S, Harjpal Pallavi, Ankar Prajyot
Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Mar 2;16(3):e55411. doi: 10.7759/cureus.55411. eCollection 2024 Mar.
Rheumatoid arthritis (RA) is a systemic autoimmune disease with profound effects on joints and extra-articular organs. This case report explores the complex treatment approach for a 54-year-old female patient who is dealing with the dual diagnosis of RA and Sjogren's syndrome (SS). RA primarily involves joint inflammation and morning stiffness leading to significant disability, while SS, another autoimmune condition, manifests with autoantibodies and lymphocytic infiltration affecting exocrine glands. The patient presented with joint and low back pain, alongside reduced mobility, portraying a complex clinical picture. Physiotherapy played a crucial role in addressing the diverse symptoms exhibited by the patient. Treatment involved Mulligan mobilization targeting sacroiliac joint dysfunction, laser therapy for pain relief, and tailored exercises focusing on joint mobility and muscle strength. Progress was monitored using the Rheumatoid Arthritis Disease Activity Index (RADAI-5) and overall quality of life assessments. Significant improvements were observed post-rehabilitation including reduced pain levels, increased joint range of motion, increased muscle strength, and enhanced sacroiliac mobility. These positive outcomes highlight the efficacy of physiotherapy in managing autoimmune rheumatic disorders. Collaboration between healthcare professionals particularly rheumatologists and physiotherapists is essential for comprehensive patient care. This case emphasizes the importance of adopting a holistic approach to managing autoimmune disorders. Physiotherapy emerges as a pivotal component in alleviating symptoms and enhancing physical function underscoring its integration into the multidisciplinary care framework for individuals facing the challenges of autoimmune rheumatic disorders.
类风湿关节炎（RA）是一种全身性自身免疫性疾病，对关节和关节外器官有深远影响。本病例报告探讨了一名54岁女性患者的复杂治疗方法，该患者同时患有类风湿关节炎和干燥综合征（SS）。类风湿关节炎主要表现为关节炎症和晨僵，导致严重残疾，而干燥综合征作为另一种自身免疫性疾病，表现为自身抗体和淋巴细胞浸润，影响外分泌腺。患者出现关节和下背部疼痛，同时活动能力下降，呈现出复杂的临床症状。物理治疗在解决患者表现出的多种症状方面发挥了关键作用。治疗包括针对骶髂关节功能障碍的米利根松动术、缓解疼痛的激光疗法，以及针对关节活动度和肌肉力量的定制锻炼。使用类风湿关节炎疾病活动指数（RADAI - 5）和总体生活质量评估来监测进展。康复后观察到显著改善，包括疼痛程度减轻、关节活动范围增加、肌肉力量增强以及骶髂关节活动度提高。这些积极结果凸显了物理治疗在管理自身免疫性风湿疾病方面的有效性。医疗保健专业人员，特别是风湿病学家和物理治疗师之间的合作对于全面的患者护理至关重要。本病例强调了采用整体方法管理自身免疫性疾病的重要性。物理治疗成为缓解症状和增强身体功能的关键组成部分，突出了其纳入面对自身免疫性风湿疾病挑战的个体多学科护理框架的必要性。
