THU0571 EFFICIENCY OF COMPLEX REHABILITATION PROGRAM IN PATIENTS WITH OSTEOARTHRITIS
Authors: E. Orlova
Journal: Annals of the Rheumatic Diseases (2020)

Background: Rehabilitation techniques and nonpharmacologic therapies help to relieve pain and improve functional status in patients with osteoarthritis (ОА) in addition to drug treatment [1–4]. Objectives: To evaluate the efficiency of 12-month complex rehabilitation program in patients with ОА. Methods: 50 patients with ОА of hand, knee and ankle joints (76% females, age of 48 to 69 years, disease duration of 2 to 15 years) were included and randomized into 2 groups. All patients received non-steroidal anti-inflammatory drugs and chondroprotectors in standard doses. 26 study group patients underwent 12-months complex rehabilitation program: laser therapy of 12 to 15 min (infrared laser radiation, wavelength of 0,89 micrometers, pulse frequency of 1200 to1500 Hz) for hand, knee and ankle joints, 3 courses for 10 sessions with a mean interval of 3,3 months; 45-min dynamic exercises using gym apparatus Enraf-Nonius under the supervision of a trainer 3 times a week; 45-min exercises for hands 3 times a week; 45-min occupational therapy, 10 sessions; wrist, ankle and knee orthoses, education program (3 daily 90-min studies); balance training on the COBS-platform 3 times a week. 24 patients received only drug therapy (control). Tender and swollen joint count, joint pain on 100-mm VAS, Lequesne index, WOMAC, hand grip strength, the average powers of knee extension and ankle flexion by EN-TreeM movement analysis, symmetry index (SI) and load distribution on the COBS-platform in the different modes were evaluated at baseline and at 12 months. Results: After 12 month in the study group tender joint count decreased by 56,2% (р&lt;0,01), swollen joint count – by 67,3% (р&lt;0,01), pain on VAS - by 54,7% (р&lt;0,01), Lequesne index – by 2,3 times (р&lt;0,01), WOMAC – by 1,8 times (р&lt;0,01). The grip strength of a more affected hand enhanced by 41,3% (р&lt;0,05), of a less affected – by 43,4% (р&lt;0,05). The average extension power of a weaker knee increased by 57,3% (р&lt;0,01), of a stronger – by 44,2% (р&lt;0,05). The average flexion power of a more affected ankle joint elevated by 34,9% (р&lt;0,05), of a less affected – by 48,2% (р&lt;0,05). The pressure on the COBS-platform of the extremity with more affected joint of the patients with ОА of knee joints increased by 11,7% (p&lt;0,05), SI – by 12,9% (p&lt;0,05) in the mode «habitual stand». The load on the limb with more affected joint elevated by 13,2% (p&lt;0,05), SI – by 25% (p&lt;0,05) in the mode «get up and sit down». The pressure on the COBS-platform of the extremity with more affected joint of the patients with ОА of ankle joints was enhanced by 14,3% (p&lt;0,05), SI – by 18,2% (p&lt;0,05) in the mode «habitual stand». The load on the limb with more affected joint was elevated by 12,8% (p&lt;0,05), SI – by 20,1% (p&lt;0,05) in the mode «tiptoe bounce (do not leave ground)». In the study group there were statistically significant differences from the control group in all parameters (р&lt;0,05). Conclusion: 12-month complex rehabilitation program relieves pain, improves functional ability, power of motion, balance and load distribution in patients with OA. References: [1]Doi T, et al. Am J Phys Med Rehabil 2008;8(4):258–69. [2]Zhang W, et al. Osteoarthritis Cartilage 2010;18:476–99. [3]Hochberg M, et al. Arthritis Care &amp; Research 2012;64(4):465–74. [4]Conaghan PG, et al. BMJ 2008;336:502–3. Disclosure of Interests: None declared