Effectiveness of Client-Centered Occupational Therapy in Patients With Rheumatoid Arthritis: Exploratory Randomized Controlled Trial (original) (raw)
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Background: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease that affects synovial membranes and typically causes joint pain and swelling. The resulting disability of RA is due to the erosion of cartilage and bone from the inflamed synovial tissue. Occupational therapy is a strategy and technique to minimize the joints’ fatigue and effort. At the same time, physical exercise reduces the impact of systemic manifestations and improves symptoms in RA. This study investigates the role of a 30-day joint economy intervention (integration of physical exercise and occupational therapy) at home on the quality of life of subjects with RA. Methods: One hundred and sixty outpatients with RA were enrolled in a single-center trial with PROBE design and were divided into the intervention group (IG), which combined joint protection movements and physical exercise to maintain muscle tone at home, and the control group (CG). Both groups included 80 patients. In all patients, dat...
Chapter 26 : Occupational therapy
Oxford University Press eBooks, 2020
People with rheumatoid arthritis can find it painful, tiring and frustrating to perform their daily activities, work, family and social responsibilities, and leisure. Whilst drug therapy has improved outcomes, many still experience limitations in their daily lives. Occupational therapy aims to: • improve clients' abilities to perform their activities and participate in their social roles; • reduce pain and fatigue; • improve or maintain physical function; • improve or maintain psychological status; • help people self-manage their condition successfully and adapt to changes in their lifestyle; • and achieve a healthy work and personal life balance. 2 People with participation restrictions have poorer psychological and physical outcomes. Helping people participate in their roles, as and when they wish to, is an important part of rehabilitation to maximise clients' quality of life. Occupational therapists use a wide range of educational, physical, social, psychological and work-related interventions to help people live their lives as successfully as possible.
BMC Health Services Research, 2023
Background People with inflammatory arthritis often experience challenges at work and balancing paid work and energy in everyday life. Low work ability is common, and people with inflammatory arthritis face high risks of losing their jobs and permanent exclusion from the labour market. Context-specific tailored rehabilitation targeting persons with inflammatory arthritis is limited. The aim of this study is to describe the development of WORK-ONa vocational rehabilitation for people with inflammatory arthritis. Methods Following the Medical Research Council's framework for complex interventions, WORK-ON was developed based on existing evidence, interviews with patients and rehabilitation clinicians, a workshop, and an iterative process. Results The six-month vocational rehabilitation, WORK-ON, consists of 1) an initial assessment and goal setting by an occupational therapist experienced in rheumatology rehabilitation, 2) coordination by the same occupational therapist and individual support, including navigating across the primary and secondary health sectors, as well as social care, 3) group sessions for peer support, and 4) optionally individually tailored consultations with physiotherapists, nurses, or social workers. Conclusion WORK-ON is ready to be tested in a feasibility study. Trial registration The Regional Committees on Health Ethics for Southern Denmark stated that no formal ethical approval was necessary in this study (20,192,000-105).
Evaluation of a community rehabilitation service for people with rheumatoid arthritis
Patient Education and Counseling, 2004
This study aims to evaluate the outcomes of a community rehabilitation service for people with rheumatoid arthritis, provided by the Community Rehabilitation Network (CRN) in Hong Kong. The three-phase community rehabilitation service consists of a number of standardized program elements, including orientation meeting, self-help course, stress management program, water exercises class, as well as informal social and recreational activities. Using a pre-, post-test non-equivalent groups design, the outcomes of 29 clients of the treatment group were compared with 16 clients of the comparison group at baseline and at the end of 9 months, using an 86-item self-completed questionnaire. The treatment group achieved significant more increases in self-efficacy of managing the illness, more increases in self-management behaviors, but no significant increases in the overall health status or health care utilization patterns, when compared with the comparison group.
Physiotherapy Canada, 2005
Purpose: To evaluate the outcomes of patients with rheumatoid arthritis (RA) receiving treatment from a rheumatology-trained primary therapist and to assess the feasibility of the research protocol. Method: The experimental (E) group received treatment from a primary therapist in addition to their overall medical care. The usual care (UC) group continued receiving usual medical care. The first 10 patients completed the Health Assessment Questionnaire, a pain visual analogue scale, and the Arthritis Community Research and Evaluation Unit RA Knowledge Questionnaire. Patients were classified as clinical responders if they showed 20% improvement in two-thirds of core measures between baseline and 6 months. Baseline assessment was performed immediately prior to randomization. All patients completed the EuroQol and a monthly health resource use questionnaire. Results: A trend towards improvement was found in the E group (n = 11) in all clinical measures at discharge (approximately 6 weeks...
Systematic Review of Educational Interventions for Rheumatoid Arthritis
American Journal of Occupational Therapy, 2016
In this study, we systematically reviewed the effectiveness of educational interventions falling within the scope of occupational therapy practice for people with rheumatoid arthritis (RA). These interventions included disease education, joint protection and energy conservation, psychosocial techniques, pain management, and a combination category. METHOD. Two databases, MEDLINE and CINAHL, and select journals were searched for randomized controlled trials published between January 2002 and June 2015. Qualitative synthesis was used for between-study comparisons. RESULTS. Twenty-two studies, with approximately 2,600 participants, were included. The interventions were found to have strong evidence for constructs that dealt with increasing coping with pain and fatigue as well as maintaining positive affect. There was limited or no evidence supporting the effectiveness of these interventions on most other measured constructs. CONCLUSION. Interventions in which a combination of educational techniques is used may complement pharmacological therapies in the care of people with RA. Future research is needed to identify specific mechanisms of change.
BMC Rheumatology
Background Although reduced work ability is a substantial problem among people with inflammatory arthritis (IA), work ability is an underexposed area in clinical practice. Evidence on vocational interventions in IA is limited, but favourable results of delivery by a physiotherapist (PT) warrant the need for further research. Therefore, we aim to evaluate the (cost-)effectiveness of a multimodal, PT-led, vocational intervention in (self-)employed people with IA compared to usual care. Methods This randomized controlled trial will include 140 people with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA) who are (self-)employed and have reduced work ability (Work Ability Index – Single Item Scale (WAS) ≤ 7/10) and/or RA/axSpA related sick leave (≤ 6 months). Participants will be randomized 1:1 to the intervention or control condition (usual care). The intervention, delivered by primary care PTs, will be personalized to each patient, consisting of 10 to 21 sessions over 12 mo...