[Rehabilitation of rheumatoid arthritis and ankylosing spondylitis: a study of the pre-requisites (author's transl)].

Rheumatoid arthritis/chronic polyarthritis and ankylosing spondylitis belong to the most common inflammatory rheumatic diseases. Owing to their progressive character they can result in morphological and functional defective conditions making rehabilitation procedures necessary. In contrast to other diseases calling for rehabilitation treatment the rehabilitation of these two diseases is in the majority of cases a life-long process, during which a change in rehabilitation goals and procedures is not seldom. Hence, rehabilitation is a dynamic process which requires flexible adjustment. A positive rehabilitation outcome is dependent upon the following factors: (1) the patient's disease (duration, stage, type of affection, progression, inflammatory and immunological activity, general condition and drug tolerance), (2) the patient's personality (age, intelligence, motivation), (3) the patient's home and vocational environments. In addition to technical pre-requisites, which are also important, the following medical ones have to be outlined: early diagnosis and initiation of therapy and the availability of a comprehensive treatment programme embracing drug, surgical, physical and balneological therapies, also as an in-patient. A further pre-requisite is the high rheumatological qualification of the responsible physician, who must maintain good contacts with the other members of the rehabilitation team. In the long run, this qualification can only be achieved with the provision of adequate training programmes, and if rheumatology is accepted as an independent discipline.