Physical therapy in rheumatoid arthritis

Physical therapy in rheumatoid arthritis is an important part of the overall treatment system and, along with the medical course, contributes to the return performance of the afflicted joints. It is particularly important that the physical therapy sessions have almost no contraindications. They can perform almost all stages of the disease except the severe exacerbation, accompanied by inflammation and severe pain in the affected joints.Лфк при ревматоидном артрите

How useful gymnastic exercises

To understand why medical gymnastics in rheumatoid arthritis should be given great attention, you need to remember that this disease and how it affects on the affected joints. Medicine klassificeret rheumatoid arthritis as a systemic autoimmune disease. It is characterized by destruction of normal tissue and the substitution of coarse connective tissue – panyam, resulting in deformity of the affected joints and limit their motor capacity up to complete immobilization.

The complex of therapeutic exercises aimed at increasing the mobility of the diseased joints and strengthening the affected rheumatoid ligaments and muscles. The result of regular exercise physical therapy is becoming a significant slowing of pathological reactions. When planning lessons you need to consider that physiotherapy in rheumatoid arthritis may be contraindicated because of the General condition of the body not associated directly with the affected joints. The reason for this may be:

  • the acute phase of any infectious disease;
  • respiratory failure to a high degree;
  • II-III degree of heart failure.

It is forbidden to engage in physiotherapy during exacerbation of chronic diseases or severe illness of any internal organ.

The subtleties of physical therapy

The first rule of the effectiveness of exercise therapy in lesions of the joints rheumatoid arthritis: exercises for arthritis should be carried out regularly. Second: in the process of execution of gymnastic exercises the load on painful joints should slowly but steadily increase due to the increase in the number of repetitions performed exercises and increase the speed of their execution. New, more complex exercises should be introduced gradually, with the improvement of the health of the patient and increase the mobility of the developed joints.

Exercise in rheumatoid arthritis cannot accomplish through force. At the end, the patient, in addition to reducing stiffness in joints, should feel energized, not tired. The complex of exercises you need to choose with consideration of the age of the patient and his ability to move. All the pain in the affected joints while performing physical therapy is unavoidable, but exercises need to be selected such to not have severe pain. In severe cases, therapy should begin with the implementation of the complex of breathing exercises and self-massage and gymnastics in the water.

During exacerbations of the disease intensity, and complexity of exercises should be reduced, and the most difficult at this time and not to exclude.

Лфк при ревматоидном артрите

Stages of classes

There are three approaches to the use of therapeutic exercises in rheumatoid arthritis, two of which provide for the execution of exercises the patients directly under the supervision of a specialist. It may be, first, the individual classes. Usually doctors recommend their patients in whom the disease is in the severe stage, as well as those who need rehabilitation after surgery.

The second approach is to group patients with the same degree of limiting the mobility of the joints. Today it is the most rational method of therapy. It is also the most popular.

The third approach involves training patients in consultative sessions. They are taught exercises and techniques that they are then on their own to perform at home. This method requires discipline and perseverance.

Usually physiotherapy in rheumatoid arthritis is based on such a scheme.


The duration and content of classes

First 1-2 days, there is a preparatory period. At this time, the doctor teaches the patient relaxation techniques and proper breathing. The duration of these sessions of 10-15 minutes per day.
Then comes the base period. Sick for two weeks daily under the supervision of a physician performs a series of basic exercises. The duration of each class 30-40 min.
The longest – closing period. Not restricted in time of exercise and duration. At this time the patient performs the exercises independently, using the knowledge and experience of previous periods.

In the General scheme of conducting classes physical therapy the doctor may make necessary adjustments depending on the condition and physical capabilities of the patient.

The basics of treatment by position

This method of gymnastics in rheumatoid arthritis used in cases when, because of neglect or aggravation of the disease the patient almost lost the ability to move. The essence of it is to use for studies of a special orthopedic mattress or any flat and rigid surface on which the patient lies.

For exercise, you need to organize patient support for the legs. In the clinic it may be moving back a special bed, and if it does not, then between the headboard and the soles of the feet establish a firm stand. A prerequisite of such treatment: at least 1 time per hour the patient must change the position of his body. If he is not able to do it yourself, then you need to help him.

The main task during this treatment – to prevent contractures (a condition in which the patient cannot fully bend or straighten the patient’s joint). For this purpose, any funds bolsters, cargo, a special splint, and in severe cases, construct duplex mattresses, allowing the legs in relaxed position to be flattened.

Approximate set of exercises for the brushes

Лфк при ревматоидном артритеGymnastics in rheumatoid arthritis largely depends on the location of joint damage. Most often this disease affects the fingers. In this case, you can apply this set of exercises.

  • Put hands on the table and, depending on health, 5-10 times to raise and lower the table surface palm. Then do the same thing, but to raise and lower only the fingers.
  • Then pull the hands in front of him, alternately 5-10 times, turning the palm up and down. Then clench the fingers into a fist, his hands stretching forward.
  • Make 5-10 rotational movement of the brushes clockwise, then against it (and Vice versa).
  • After that, you need 5-10 times to RUB palms together, then put your elbows on the table and folded the fingers to the castle. 5-10 times without lifting from the surface, flatten, and raise the elbows.
  • To do alternately 5-10 times each movement of the fingers first up and down then left to right and finish in a circular motion.
  • Then touch also 5-10 times out of the corner of the nail of each finger to the edge of his thumb nail.
  • Relax your hands, rotate the brush in the wrist joint.
  • To pick up a stick and run it 5-10 times with your fingers from the bottom up.
  • To complete the complex exercise with a small soft ball, rolling it out first on the surface of the table, and then between your palms.

    Exercises for the shoulder girdle

    Gymnastics in rheumatoid arthritis of the shoulder girdle are primarily aimed at restoring the mobility of shoulder joints and prevention of contractures in them. Can be used by different types of movements: isometric and dynamic.

    Isometric techniques are applied when pronounced limitation of the affected joints. Their main task is to keep in tone the muscles of the shoulder. The simplest example of such exercises: lie back on a flat surface and as hard as possible to push her hands outstretched.

    Dynamic methods involve certain movements. Schematically, it looks like.

  • You need to raise and lower the shoulders.
  • Then they do a circular motion back and forth.
  • Clasp your palms elbows. Without lifting your hands, simultaneously to raise and lower both elbows.
  • Then put hands on shoulders, moving alternately forward right and left elbows.
  • Lying on your back, hold your arms up in front of him. Bending at the elbows to press hands to his chest. Straighten the arms and pulling them along the body.
  • Then stand up, put hands on hips and, at the same time raising them to the sides to make the head.
  • To complete the set of exercises you can «hug» yourself by the shoulders. As in the case of brushes, each exercise should be repeated 5-10 times.

    Medical complex in lesions of the feet

    Лфк при ревматоидном артритеScheme dynamic physical therapy looks like. Lie on your back, leaving your soles from the surface, alternately bend and straighten your knees. Raise the knees bent legs up. Breed them in hand and together. Twist legs in the air, as during the Cycling. To do lying Mahi straight legs alternately. Then get up and, holding on to the strut, repeat the leg swings standing. Bend the leg at the knee and to perform its circular motion in the hip joint. To finish the set of exercises semicircular movements straight leg.

    To run legs of isometric exercises need the help of an assistant. Its task is to fix the leg and to oppose its movement. Describes the schema of the physical therapy exercises are not a dogma, and the doctor, based on their health condition of a patient may be excluded from these separate exercises and to introduce the scheme more complex. The key to successful treatment of rheumatoid arthritis strictly follow the doctor’s recommendations.

    It should be understood that physical therapy was not able to restore the diseased connective tissue of the joints, but it exercises develop the remaining intact tissue and thus increase the mobility of the joints.

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