Yuliya Fedorchenko, Olena Zimba, Ainur B Qumar, Marlen Yessirkepov, Burhan Fatih Kocyigit
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引用次数: 0
摘要
老年人类风湿关节炎（RA）是一个复杂的临床挑战，与年龄相关的合并症、肌肉骨骼变性和社会心理因素加剧了这一挑战，所有这些都导致严重的活动能力限制和生活质量下降。这篇叙述性综述综合了目前关于康复干预以增强RA患者身体功能的证据，重点是步行，水疗法，桑拿和按摩疗法以及瑜伽。通过对Medline/PubMed、Scopus、Web of Science和DOAJ（截至2025年5月）的全面搜索，发现了强调结构化体育活动（PA）在减少疾病活动、疲劳和疼痛，同时改善功能能力和心理健康方面的功效的研究。步行干预，包括高强度间歇方案，显示出免疫调节和心脏代谢益处，疾病活动评分（DAS28）和炎症标志物显著降低。水中疗法，利用水的浮力，改善功能结果，减少抑郁症状，而桑拿和按摩疗法提供疼痛缓解和增强灵活性。瑜伽作为一种身心练习，可以显著降低疾病活动，增强身体机能和心理健康。可穿戴技术，如活动记录仪和计步器，通过为动态目标设定提供实时数据，支持个性化的锻炼方案。欧洲风湿病协会联盟（EULAR）和美国风湿病学会（ACR）的指导方针提倡将量身定制的运动纳入RA管理。尽管有这些好处，但由于疼痛、疲劳和心理障碍，坚持治疗仍然具有挑战性，需要个性化的生物心理社会方法。本综述为风湿病专家实施循证康复策略提供了实用建议，强调多学科护理以优化老年RA患者的活动能力和生活质量。
Physical activity of older patients with rheumatoid arthritis.
Rheumatoid arthritis (RA) in older adults presents a complex clinical challenge, exacerbated by age-related comorbidities, musculoskeletal degeneration, and psychosocial factors, all contributing to significant mobility limitations and reduced quality of life. This narrative review synthesizes current evidence on rehabilitation interventions to enhance physical function in RA patients, focusing on walking, aquatic therapy, sauna and massage therapies, and yoga. A comprehensive search of Medline/PubMed, Scopus, Web of Science, and DOAJ (up to May 2025) identified studies highlighting the efficacy of structured physical activity (PA) in reducing disease activity, fatigue, and pain, while improving functional capacity and mental health. Walking interventions, including high-intensity interval protocols, demonstrate immunomodulatory and cardiometabolic benefits, with significant reductions in Disease Activity Score (DAS28) and inflammatory markers. Aquatic therapy, leveraging water's buoyancy, improves functional outcomes and reduces depressive symptoms, while sauna and massage therapies offer pain relief and enhanced flexibility. Yoga, as a mind-body practice, significantly lowers disease activity and enhances physical function and psychological well-being. Wearable technologies, such as actigraphy and pedometry, support personalized exercise regimens by providing real-time data for dynamic goal-setting. The European Alliance of Associations for Rheumatology (EULAR) and American College of Rheumatology (ACR) guidelines advocate for tailored exercise integration into RA management. Despite these benefits, adherence remains challenging due to pain, fatigue, and psychological barriers, necessitating individualized, biopsychosocial approaches. This review provides practical recommendations for rheumatology specialists to implement evidence-based rehabilitation strategies, emphasizing multidisciplinary care to optimize mobility and quality of life in older adults with RA.
期刊介绍：
RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology.
RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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