Fedorchenko Yuliya, Zimba Olena, Qumar Ainur B, Yessirkepov Marlen, Kocyigit Burhan Fatih
Department of Pathophysiology, Ivano-Frankivsk National Medical University, Ivano-Frankivs'k, Ukraine.
Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland.
Rheumatol Int. 2025 Jun 25;45(7):157. doi: 10.1007/s00296-025-05901-8.
Rheumatoid arthritis (RA) in older adults presents a complex clinical challenge, exacerbated by age-related comorbidities, musculoskeletal degeneration, and psychosocial factors, all contributing to significant mobility limitations and reduced quality of life. This narrative review synthesizes current evidence on rehabilitation interventions to enhance physical function in RA patients, focusing on walking, aquatic therapy, sauna and massage therapies, and yoga. A comprehensive search of Medline/PubMed, Scopus, Web of Science, and DOAJ (up to May 2025) identified studies highlighting the efficacy of structured physical activity (PA) in reducing disease activity, fatigue, and pain, while improving functional capacity and mental health. Walking interventions, including high-intensity interval protocols, demonstrate immunomodulatory and cardiometabolic benefits, with significant reductions in Disease Activity Score (DAS28) and inflammatory markers. Aquatic therapy, leveraging water's buoyancy, improves functional outcomes and reduces depressive symptoms, while sauna and massage therapies offer pain relief and enhanced flexibility. Yoga, as a mind-body practice, significantly lowers disease activity and enhances physical function and psychological well-being. Wearable technologies, such as actigraphy and pedometry, support personalized exercise regimens by providing real-time data for dynamic goal-setting. The European Alliance of Associations for Rheumatology (EULAR) and American College of Rheumatology (ACR) guidelines advocate for tailored exercise integration into RA management. Despite these benefits, adherence remains challenging due to pain, fatigue, and psychological barriers, necessitating individualized, biopsychosocial approaches. This review provides practical recommendations for rheumatology specialists to implement evidence-based rehabilitation strategies, emphasizing multidisciplinary care to optimize mobility and quality of life in older adults with RA.
老年类风湿关节炎（RA）带来了复杂的临床挑战，与年龄相关的合并症、肌肉骨骼退变和心理社会因素使其更加恶化，所有这些因素都会导致严重的活动受限和生活质量下降。本叙述性综述综合了当前关于康复干预以增强RA患者身体功能的证据，重点关注步行、水疗、桑拿和按摩疗法以及瑜伽。对Medline/PubMed、Scopus、科学网和DOAJ（截至2025年5月）进行的全面检索确定了一些研究，这些研究强调了结构化体育活动（PA）在降低疾病活动度、疲劳和疼痛方面的功效，同时改善功能能力和心理健康。步行干预，包括高强度间歇方案，显示出免疫调节和心脏代谢益处，疾病活动评分（DAS28）和炎症标志物显著降低。水疗利用水的浮力改善功能结局并减轻抑郁症状，而桑拿和按摩疗法则提供疼痛缓解并增强灵活性。瑜伽作为一种身心练习，可显著降低疾病活动度并增强身体功能和心理健康。可穿戴技术，如活动记录仪和计步器，通过提供实时数据以进行动态目标设定来支持个性化运动方案。欧洲风湿病协会联盟（EULAR）和美国风湿病学会（ACR）指南提倡将量身定制的运动纳入RA管理。尽管有这些益处，但由于疼痛、疲劳和心理障碍，坚持锻炼仍然具有挑战性，因此需要采用个性化的生物心理社会方法。本综述为风湿病专科医生实施循证康复策略提供了实用建议，强调多学科护理以优化老年RA患者的活动能力和生活质量。
