PHYSIOTHERAPEUTIC PROCEDURES IN RHEUMATOID ARTHRITIS OF THE HAND

Reumatoidni artritis jedna je od najčešćih i najtežih autoimunih i kroničnih upalnih bolesti koja dovodi do ireverzibilnih oštećenja zglobova i sistemskih oštećenja ostalih organa, te uzrokuje tešku invalidnost i velik stupanj mortaliteta. Najčešća lokalizacija zahvaćenih zglobova kod reumatoidnog artritisa su šake, te u 70% oboljelih dovodi do progresivnog razvoja deformiteta i gubitka funkcije šaka i ručnih zglobova praćenih bolovima, te uzrokuje znatne teškoće u svakodnevnom životu, kao i brojne smetnje vezanih uz funkcioniranje u zajednici. Napredovanjem bolesti budu zahvaćeni gotovo svi veliki i mali zglobovi šake stvarajući deformacije tipične za reumatoidni artritis. Rana dijagnoza od presudne je važnosti za ishod liječenja. Liječenje je složeno i dugotrajno te zahtjeva multidisciplinarni pristup. Unatoč sve većem broju lijekova koji modificiraju tijek bolesti, bol, kontrakture, deformacije i nesposobnost, prate život velikog broja reumatoloških bolesnika, pa je zato fizikalna terapija, prepoznata kao sastavni dio kompleksnog liječenja bolesnika sa RA. Najčešći modaliteti fizikalne terapije koji se koriste u reumatologiji su termoterapijski, elektroterapijski, balneoterapijski, kao i opskrba pomoćnim sredstvima i pomagalima te edukacija. Vježbe su kruna fizikalne terapije, a sve ostale procedure su u funkciji pripreme zgloba za aktivno izvođenje pokreta. Fizioterapeut kao jedan od članova zdravstvene djelatnosti najveći kontakt ima sa samim pacijentom te mu je on idealan izvor znanja i edukacije.Rheumatoid arthritis is one of the most common and most severe autoimmune and chronic inflammatory diseases which causes irreversible damage to joints and systemic damage of other organs in addition to causing severe disability and having a high degree of mortality. The most common localization of the affected joints in rheumatoid arthritis is the first, and in 70% of the patients leads to progressive deformity development and loss of functionality of fists and hand joints accompanied by pain, it also causes considerable difficulties in everyday life as well as numerous interference with functioning in the community. The spread of the disease affects almost all large and small hand joints, creating deformities typical for rheumatoid arthritis. Early diagnosis is of crucial importance for the outcome of treatment. Treatment is complex and long-lasting and requires a multidisciplinary approach. Despite the increasing number of medications that modify the course of the disease, the pain, contractures, deformities, and inability are present in the life of a large number of rheumatoid patients, which is why physical therapy is recognized as an integral part of the complex treatment of patients with rheumatoid arthritis. The most common physiotherapy regiments used in rheumatology are thermotherapy, electrotherapy, balneotherapy, as well as a supply of auxiliary supplies, aids and education. Exercises are the crowning part of physical therapy, and all the other procedures have the purpose of preparing joints for active movement performance. Physiotherapist, as one of the members in healthcare has the greatest contact with the patient himself, and he is the ideal source of knowledge and education for patient