ESULTS OF X-RAY EXAMINATION AND DETERMINATION OF BODY MASS INDEX IN PATIENTS WITH RHEUMATOID ARTHRITIS
Rheumatoid arthritis (RA) is a chronic progressive systemic disease of the connective tissue affecting the joints, mainly small, of the erosive-destructive polyarthritis type, and frequent systemic inflammatory damage to internal organs. The disease is registered in all countries of the world with a frequency from 0.4 to 1.5 %. Along with drug therapy, non-drug treatment of patients with rheumatoid arthritis is also used. In particular, an important role is given to the means of physical therapy. Determining the level of functional and organic disorders is important in the treatment and physical therapy of patients with rheumatoid arthritis, taking into account the International classification of functioning, limitations of life and health (ICF).
The purpose is to determine the level of functional and organic disorders of the affected joints in patients with rheumatoid arthritis at different stages of the disease, in order to form a personalized approach to rehabilitation.
Materials and methods. Analysis and generalization of data from scientific and methodological field-related literature, survey, medical history taking, objective examination, instrumental research methods (X-rays), determination of body mass index (Quetelet index), as well as methods of mathematical statistics. The study was conducted on the basis of the rheumatology department of the Municipal Enterprise “Rivne Regional Clinical Hospital named after Yuriy Semeniuk” in Rivne throughout the period from 2016 to 2018. 216 young and middle-aged patients with rheumatoid arthritis took part in the examination.
Results. The authors suggested a scheme (algorithm) of the rehabilitation examination that included a survey, medical history taking, objective examination, the results of instrumental research methods (primarily X-rays), determination of the clinical form of rheumatoid arthritis, the disease stage and degree, as well as the course of the disease. During the initial examination of the patients with rheumatoid arthritis, a predominance of women was found, namely 82%. The main complaints of the patients were: stiffness in the joints of the upper and lower limbs after sleep, pain in the joints, swelling in the small joints of the hands, numbness of the fingers and toes, limitation of movements, periodic pains in the lumbar region. The radiological stage of rheumatoid arthritis was determined according to O. Steinbrocker et al. (1949). Stage I of rheumatoid arthritis was diagnosed in 50 patients (23%), stage II – in 102 patients (47%), and stage III – in 64 cases (30%). Patients with rheumatoid arthritis of the IV radiological stage were not included in the study. All patients underwent BMI (Quetelet index) during the initial examination. It was found that among young people (25 – 44 years old), the average BMI is 25.42, for middle-aged patients (45 – 49 years old) it amounts to 27.27, which corresponds to excess body weight. This is a negative factor in the development and progression of rheumatoid arthritis and a factor to which a comprehensive program of physical therapy will be directed.
Conclusions. During the initial examination, it was established that the majority of patients (47 %), have the II radiological stage of the disease with characteristic radiological symptoms. One of the risk factors for the development of rheumatoid arthritis is the increased body weight [4, 6]. There is an urgent need to develop and study the effectiveness of a physical therapy program that could reduce the symptoms of the disease, the level of functional and organic disorders and improve the quality of life of patients.
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