THE IMPORTANCE OF NUTRITION AND PHYSIOTHERAPY IN RHEUMATOID ARTRITIS

Reumatoidni artritis je kronična sustavna upalna bolest zglobova i vezivnog tkiva, nepoznatog uzroka. Najčešće zahvaćeni zglobovi su mali zglobovi šake i stopala. Simptomi kao što su bol, jutarnja zakočenost, reumatoidni čvorići, deformacije zglobova, kontrakture, anemija, slabost liječe se farmakološkom i nefarmakološkom terapijom. Od velike je važnost pravilna prehrana koja može usporiti napredovanje bolesti i ublažiti simptome reumatoidnog artritisa. Preporučuje se konzumiranje mediteranske prehrane bogate omega masnim kiselinama, vitamina D, raznog bobičastog voća, bezglutenske i veganske prehrane. Fizioterapija se provodi kroz tri faze: akutna, subakutna i kronična. Rehabilitacijski proces započinje fizioterapijskom procjenom. Fizioterapeuti služe se subjektivnim i objektivnim pregledom, analizom rezultata i planom terapije, ili skraćeno SOAP metodom kao i različitim specifičnim upitnicima kao što su indeks aktivnosti bolesti (dessease activity index – DAS28 i DAS44), funkcionalni status (Helth Assesment Questionary ili skraćeno HAQ), Ritchie indeks, te test za procjenu stanja bolesti (Rheumatoid and Arthritis Qutcome Score ili skraćeno RAOS). Fizioterapijska intervencija podrazumijeva krioterapiju, kineziterapiju, elektroterapiju, hidroterapiju i balneoterapiju, te edukaciju pacijenta o primjeni ortopedskih pomagala i zaštitnih položaja.Rheumatoid arthritis is a chronic systemic inflammatory disease of the joints and connective tissue, of unknown cause. The most commonly affected joints are the small joints of the hand and foot. Symptoms such as pain, morning stiffness, rheumatoid nodules, joint deformities, contractures, anemia, weakness are treated with pharmacological and nonpharmacological therapy. Of great importance is a proper diet that can slow the progression of the disease and alleviate the symptoms of rheumatoid arthritis. It is recommended to consume a Mediterranean diet rich in omega fatty acids, vitamin D, various berries, gluten-free and vegan diets. Physiotherapists use subjective and objective examination, analysis of results and treatment plan, or short SOAP method as well as various specific questionnaires such as disease activity index (DAS28 and DAS44), functional status (Helth Assessment Questionary or HAQ), Ritchie index, and a test to assess the condition of the disease (Rheumatoid and Arthritis Qutcome Score or RAOS). Physiotherapy intervention includes cryotherapy, kinesitherapy, electrotherapy, hydrotherapy and balneotherapy, as well as educating the patient about the use of orthopedic aids and protective positions