REVIEW - Exercise therapy and orthotic devices in RA

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Medscape

Posted 06/10/2008

Vicki Oldfield; T. Felson

Exercise Therapy and Orthotic Devices in Rheumatoid Arthritis:

Evidence-Based Review

Rheumatoid arthritis (RA) is a chronic, systemic disease characterised

by inflammation and gradual destruction of the peripheral joints.[1,2]

It affects up to 1% of the population worldwide and occurs in almost

twice as many women as men.[2] While the precise aetiology of the

disease is unknown, its clinical course is well understood; joint

destruction begins within a few weeks of the onset of symptoms of

pain, joint stiffness and/or fatigue.

Involvement of the hands and feet is common. Inflammation of the wrist

joint occurs in approximately 75% of RA patients and reduced grip

strength and dexterity is frequent.[3] Up to 92% of RA patients

experience painful, disabling foot deformities such as hallux valgus,

splaying of the forefoot, flattened longitudinal arches and valgus

hindfoot.[4,5] RA patients characteristically display a slow shuffling

gait with short strides that lacks the usual heel-toe pattern. These

local effects, in conjunction with the general impact of the disease,

cause progressive functional impairment that can prevent patients from

participating in work, leisure and normal daily living activities;[2]

up to 30% of patients cannot work within 3 years of diagnosis because

of RA-associated disability.[6] Consequently, RA is associated with a

substantial negative burden on health-related quality of life

(HRQL).[1,7]

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http://www.medscape.com/viewarticle/573646

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