doiSerbia

Influence of balneophysical therapy on activity, functional capacity, and quality of life in patients with rheumatoid arthritis

Stojanović Sonja (Institut za prevenciju, lečenje i rehabilitaciju reumatskih i kardiovaskularnih oboljenja, Niška Banja)
Dimić Aleksandar (Institut za prevenciju, lečenje i rehabilitaciju reumatskih i kardiovaskularnih oboljenja, Niška Banja)
Stamenković Bojana (Institut za prevenciju, lečenje i rehabilitaciju reumatskih i kardiovaskularnih oboljenja, Niška Banja)
Stanković Aleksandra (Institut za prevenciju, lečenje i rehabilitaciju reumatskih i kardiovaskularnih oboljenja, Niška Banja)
Nedović Jovan (Institut za prevenciju, lečenje i rehabilitaciju reumatskih i kardiovaskularnih oboljenja, Niška Banja)

Introduction It has been well known that balneophysical therapy has a therapeutic effect on clinical and biological parameters of disease activity in the patients with rheumatoid arthritis (RA). Objective. To determine the influence of balneophysical therapy on functional capacity, activity and quality of life of the patients with RA primarily treated with some of disease modifying antirheumatic drugs. Methods. The study enrolled 73 patients with RA treated with some of disease modifying antirheumatic drugs (Methotrexate in 85% of patients). During hospitalization at the Clinical Rheumatologic Department of the Institute 'Niska Banja', the patients were treated, beside the medicamentous therapy, by hydrotherapy (oligomineral, homeothermic, low radioactive water), mineral peloid therapy, electrotherapy and kinesiotherapy. Before and after balneotherapy, the patients filled in the Health Assessment Questionnaire (HAQ) and the Quality of Life Rheumatoid Arthritis (QOL-RA) scale. The Disease Activity Score (DAS) 28 was used to measure the disease activity before and after balneotherapy. A possible value of HAQ was from 0 to 3, and QOL-RA from 0 to 10. Results. The mean value of the duration of balneophysical therapy was 14.7±4.8 days. We found significant improvement of functional capacity in the patients with RA. The average HAQ score before balneotherapy was 1.07±0.61, and 0.86±0.55 after balneotherapy, which was statistically significantly lower (p<0.05). DAS 28 after balneotherapy was also statistically significantly lower than DAS 28 before balneotherapy: the mean value of DAS 28 before therapy was 6.30±0.81 and after therapy 5.48±0.75 (p<0.001). The quality of life significantly improved after balneophysical therapy: the mean value of QOL-RA scale before therapy was 5.38±1.62 and after therapy 7.35±1.81 (p<0.05). Conclusion. Balneophysical therapy, when properly dosed, is an effective, adjuvant therapy in the patients with RA of mild disease activity. Balneophysical therapy has a positive influence on disease activity, functional capacity and quality of life in the patients with rheumatoid arthritis.

Keywords: rheumatoid arthritis, balneophysical therapy, quality of life, functional capacity