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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2011; 21(6): 297-310
DOI: 10.1055/s-0031-1276996
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© Georg Thieme Verlag KG Stuttgart · New York

Rehabilitation von Patienten mit rheumatoider Arthritis

Rehabilitation of Patients with Rheumatoid ArthritisK.  Kerschan-Schindl1 , K.  Machold2
  • 1Universitätsklinik für Physikalische Medizin und Rehabilitation, MUW, AKH Wien, Österreich
  • 2Universitätsklinik für Innere Medizin III, Klinische Abteilung für Rheumatologie, MUW, AKH Wien, Österreich
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Publikationsdatum:
19. Dezember 2011 (online)

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Zusammenfassung

Die rheumatoide Arthritis (RA) ist eine chronische, entzündliche Gelenkerkrankung, welche mit Gelenkschmerz, -schwellung und -destruktion einhergeht. Neben genetischen Faktoren scheint auch der Lebensstil des Betroffenen einen Einfluss auf die Entstehung der Krankheit zu haben. Da die Klassifizierung mithilfe der klassischen ACR-Kriterien (ACR: American College of Rheumatology) nur für chronifizierte Formen der RA geeignet, allerdings eine möglichst frühzeitige medikamentöse Therapie das Ziel ist, wurden nun speziell zur Klassifizierung der Früharthritis die neuen ACR- / EULAR-Klassifikationskriterien (EULAR: European League Against Rheumatism) entwickelt. Die krankheitsspezifische Medikation hat sich sehr verbessert; dennoch sind Patienten, die an einer RA leiden, infolge der chronischen Entzündungen häufig in den Bereichen körperliche Struktur und Funktion, Aktivitäten und Partizipation eingeschränkt. Mittels der internationalen Klassifizierung der funktionalen Gesundheit (ICF) können diese Probleme des Betroffenen erfasst werden. Dies ist Voraussetzung für eine komplexe, durch ein multidisziplinäres Team durchgeführte, Rehabilitation. Die therapeutischen Ansätze der Rehabilitation umfassen die Übungs- und Trainingstherapie, Ergotherapie, physikalische Modalitäten, psychologische Betreuung und diätische Maßnahmen. Ein solches Rehabilitationsprogramm sollte individuell angepasst werden, um die Funktion und Selbstständigkeit des Patienten möglichst lange zu erhalten.

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterised by joint swelling, joint tenderness and joint destruction, leading to severe disability and premature mortality. RA is considered an autoimmune disease, however, lifestyle factors also influence the clinical manifestation of the disease. The ACR (American College of Rheumatology)-classification criteria have a significant limitation in discriminating patients suffering of early RA. To be able to treat these patients as soon as possible, the new ACR / EULAR- (European League Against Rheumatism-) classification criteria were developed. Despite medical treatment RA-patients often have deficits in body structure and function, activities, and participation. The international classification of functioning, disability and health (ICF) comprehensive core set for rheumatoid arthritis helps to assess patients’ daily functioning and to plan a complex rehabilitation performed by a multidisciplinary team. Non-pharmacologic therapeutic options include exercise, occupational therapy, different physical modalities, psychologic care, and special diets. Such a rehabilitation program has to be individualised to optimise the effect and to conserve the patient’s function and independence as long as possible.

Schlüsselwörter

rheumatoide Arthritis - Rehabilitation - krankheitsspezifische Medikation - Übungs- und Trainingstherapie - physikalisch-therapeutische Modalitäten

Keywords

rheumatoid arthritis - rehabilitation - disease-specific medication - exercise - physical modalities

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Univ.-Prof. Dr. Katharina Kerschan-Schindl

Universitätsklinik für Physikalische Medizin und Rehabilitation, MUW, AKH Wien

Währinger Gürtel 18–20

1090 Wien, Österreich

eMail: Katharina.Kerschan-Schindl@meduniwien.ac.at