Introduction: Physiotherapy is an integral part of the non-drug treatment strategy for
rheumatological conditions. The evidence for its effects is not formal. The
objective was to evaluate the impact of physiotherapy in the management of
rheumatological disorders. Methods: 6-month case-control study (December
15, 2021 to June 20, 2022) at Ignace Deen University Hospital (Conakry).
Patients with rheumatological disease who received drug therapy and
physiotherapy were included in the case group. Age- and sex-matched controls
had rheumatological conditions, treated without physiotherapy. The evaluation questionnaires were used: WOMAC (osteoarthritis), EIFEL (low back pain), NDI (neck pain), SPADI (shoulder).
Patients with heart failure, respiratory failure and/or skin infection were not
included. Results: We collected 773 patients (389 cases and 384
controls) with a mean age of 53.8 years ± 12.2 with female predominance
(56.8%). Patients were mainly followed for osteoarthritis (65.2%).
Rheumatological conditions managed were knee-based (119; 30.6%), lumbar spine
(220; 56.6%), shoulders (27; 6.9%) and cervical spine (23; 5.9%). For an
average duration of 53.4±12.2 minutes per session,
patients had benefited from a median of 19 physiotherapy sessions. After 3
months, the baseline mean VAS of 6/10 improved to 2.2 ± 1.6 for cases and 5.7 ±
1.2 for controls. Functional capacity was improved (WOMAC: 41.8±22.7 vs. 18.3±7.3). The
satisfaction of patients treated with physiotherapy was 20 times higher than in
controls. Conclusion:
References
[1]
Escalas, C., Dalichampt, M., Dougados, M. and Poiraudeau, S. (2016) évaluation de l’effet de la kinésithérapie dans une cohorte de patients atteints de spondyloarthrite axiale débutante. Données de la cohorte DESIR. Revue du Rhumatisme, 83, 352-357. https://doi.org/10.1016/j.rhum.2016.05.004
[2]
Fritz, J.M., Magel, J.S., et al. (2015) Early Physical Therapy vs Usual Care in Patients with Recent-Onset Low Back Pain: A Randomized Clinical Trial. JAMA, 314, 1459-1467. https://doi.org/10.1001/jama.2015.11648
[3]
Skou, S.T. and Roos, E.M. (2019) Physical Therapy for Patients with Knee and Hip Osteoarthritis: Supervised, Active Treatment Is Current Best Practice. Clinical and Experimental Rheumatology, 37, 112-117.
[4]
Tunwattanapong, P., Kongkasuwan, R. and Kuptniratsaikul, V. (2016) The Effectiveness of a Neck and Shoulder Stretching Exercise Program among Office Workers with Neck Pain: A Randomized Controlled Trial. Clinical Rehabilitation, 30, 64-72. https://doi.org/10.1177/0269215515575747
[5]
Kharrat, O., Lebib, S., Miri, I., Aloulou, I., Othmani, I., Ben Souilah, R., et al. (2013) Prise en charge de la polyarthrite rhumatoïde en médecine physique réadaptation: Expérience en Tunisie. Journal de Réadaptation Médicale: Pratique et Formation en Médecine Physique et de Réadaptation, 33, 54-64. https://doi.org/10.1016/j.jrm.2013.02.001
[6]
Muzembo Ndundu, J. and Makekita Kiadakulu, S. (2012) évaluation fonctionnelle d’une population des lombalgiques de Kinshasa par l’échelle d’EIFEL Journal de Réadaptation Médicale: Pratique et Formation en Médecine Physique et de Réadaptation, 32, 103-107. https://doi.org/10.1016/j.jrm.2012.09.002
[7]
Bennell, K.L., Egerton, T., Martin, J., Abbott, J.H., Metcalf, B., McManus, F., et al. (2014) Effect of Physical Therapy on Pain and Function in Patients with Hip Osteoarthritis: A Randomized Clinical Trial. JAMA, 311, 1987-1997. https://doi.org/10.1001/jama.2014.4591
[8]
Bellamy, N., Buchanan, W.W., Goldsmith, C.H., Campbell, J. and Stit, L.W.J. (1995) Validation of WOMAC: A Health Status Instrument for Measuring Clinically Important Patient Relevant Outcomes to Antirheumatic Drug Therapy in Patients with Osteoarthritis of the Hip or Knee. Journal of Rheumatology, 15, 1833-1840.
[9]
Coste, J., Le Parc, J.M., Berge, E., et al. (1993) French Validation of a Disability Rating Scale for the Evaluation of Low Back Pain (EIFEL Questionnaire). Revue Du Rhumatisme (Ed. Francaise: 1993), 60, 335-341.
[10]
Vernon, H. (2008) The Neck Disability Index: State-of-the-Art, 1991-2008. Journal of Manipulative and Physiological Therapeutics, 31, 491-502. https://doi.org/10.1016/j.jmpt.2008.08.006
[11]
Angst, F., Schwyzer, H.-K., Aeschlimann, A., Simmen, B.R. and Goldhahn, J. (2011) Measures of Adult Shoulder Function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Its Short Version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society Standardized Shoulder. Arthritis Care and Research, 63, S174-S188. https://doi.org/10.1002/acr.20630
[12]
Houzou, P., Oniankitan, O., Kakpovi, K., Tagbor, K.C., Fianyo, E., Mijiyawa, M., et al. (2013) Profil des affections rhumatismales chez 13517 patients ouest-africains. La Tunisie Médicale, 91, 16-20.
[13]
Nzambi, J.D., Malemba, J.J., Lebughe, L.P., Mpembele, E., Mulenga, C., Lukusa, A., et al. (2017) The Epidemiology of Rheumatic Disorders in a Rural Area of the Democratic Republic of Congo (DRC): A COPCORD Study. African Journal of Rheumatology, 5, 64-69.
[14]
Kouakou N’Zue, M., Akissi, L.N., Eti, E., Daboiko, J., Gabla, A., Odi, R., Traoté, A. and Azttia, Y. (1989) La rhumatologie en milieu hospitalier ivoirien: Données épidémiologiques à propos de 2294 cas. Abidjan, 20 p.
[15]
Leaver, A.M., Refshauge, K.M., Maher, C.G., et al. (2010) Conservative Interventions Provide Short-Term Relief for Non-Specific Neck Pain: A Systematic Review. Journal of Physiotherapy, 56, 73-85. https://doi.org/10.1016/S1836-9553(10)70037-0
[16]
Ouédraogo, D.-D., Ntsiba, H., Tiendrébéogo Zabsonré, J., Tiéno, H., Bokossa, L.I., Kaboré, F., Drabo, J., et al. (2014) Clinical Spectrum of Rheumatologic Diseases in a Department of Rheumatology in Ouagadougou (Burkina Faso). Clinical Rheumatology, 33, 385-389. https://doi.org/10.1007/s10067-013-2455-4
[17]
Rakotomalala, H.N., Razanaparany, M.O., et al. (2016) Cinq ans de Rhumatologie à Madagascar: Dures réalités et quelles perspectives? Revue Marocaine de Rhumatologie, 37, 33-38.
[18]
Deyle, G.D., Allen, C.S., Allison, S.C., Gill, N.W., Hando, B.R., Petersen, E.J. Dusenberry, D.I. and Rhon, D.I. (2020) Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee. The New England Journal of Medicine, 382, 1420-1429. https://doi.org/10.1056/NEJMoa1905877
[19]
Evcik, D. and Sonel, B. (2002) Effectiveness of a Home-Based Exercise Therapy and Walking Program on Osteoarthritis of the Knee. Rheumatology International, 22, 103-106. https://doi.org/10.1007/s00296-002-0198-7
[20]
O’Reilly, S.C., Muir, K.R. and Doherty, M. (1999) Effectiveness of Home Exercise on Pain and Disability from Osteoarthritis of the Knee: A Randomised Controlled Trial. Annals of the Rheumatic Diseases, 58, 15-19. https://doi.org/10.1136/ard.58.1.15
[21]
Sherman, K.J., Cherkin, D.C., Hawkes, R.J., Miglioretti, D.L. and Deyo, R.A. (2009) Randomized Trial of Therapeutic Massage for Chronic Neck Pain. The Clinical Journal of Pain, 25, 233-238. https://doi.org/10.1097/AJP.0b013e31818b7912
[22]
Brennan, K., Elifritz, K.M., Comire, M.M. and Jupiter, D.C. (2021) Rate and Maintenance of Improvement of Myofascial Pain with Dry Needling alone vs. Dry Needling with Intramuscular Electrical Stimulation: A Randomized Controlled Trial. Journal of Manual and Manipulative Therapy, 29, 216-226. https://doi.org/10.1080/10669817.2020.1824469
[23]
Evans, R., Bronfort, G., Schulz, C., Maiers, M., Bracha, Y., Svendsen, K., et al. (2012) Supervised Exercise with and without Spinal Manipulation Performs Similarly and Better Than Home Exercise for Chronic Neck Pain: A Randomized Controlled Trial. Spine, 37, 903-914. https://doi.org/10.1097/BRS.0b013e31823b3bdf
[24]
Littlewood, C., Bateman, M., Brown, K., Bury, J., Mawson, S., May, S., et al. (2016) A Self-Managed Single Exercise Programme versus Usual Physiotherapy Treatment for Rotator Cuff Tendinopathy: A Randomised Controlled Trial (The SELF Study). Clinical Rehabilitation, 30, 686-696. https://doi.org/10.1177/0269215515593784
[25]
Mueller, M.J., Sorensen, C.J., McGill, J.B., Clark, B.R., Lang, C.E., Chen, L., et al. (2018) Effect of a Shoulder Movement Intervention on Joint Mobility, Pain, and Disability in People With Diabetes: A Randomized Controlled Trial. Physical Therapy, 98, 745-753. https://doi.org/10.1093/ptj/pzy070
[26]
Mohamed, A.A., Jan, Y.K., El Sayed, W.H., Wanis, M.E.A. and Yamany, A.A. (2020) Dynamic Scapular Recognition Exercise Improves Scapular upward Rotation and Shoulder Pain and Disability in Patients with Adhesive Capsulitis: A Randomized Controlled Trial. Journal of Manual and Manipulative Therapy, 28, 146-158. https://doi.org/10.1080/10669817.2019.1622896
[27]
Facci, L.M., Nowotny, J.P., Tormem, F. and Trevisani, V.F. (2011) Effects of Transcutaneous Electrical Nerve Stimulation (TENS) and Interferential Currents (IFC) in Patients with Nonspecific Chronic Low Back Pain: Randomized Clinical Trial. São Paulo Medical Journal, 129, 206-216. https://doi.org/10.1590/S1516-31802011000400003
[28]
Hahn, S.-W. (2002) The Effects of Exercise Therapy and Transcutaneous Electrical Nerve Stimulation for the Alleviation of Low Back Pain after Coronary Angiography. Korean Society of Adult Nursing, 14, 222-232.
