Differenzialindikative Verordnung nichtpharmakologischer Therapien bei der rheumatoiden Arthritis

Zusammenfassung

Die rheumatoide Arthritis führt als häufig chronisch progredient und destruierend verlaufende Gelenkerkrankung zu erheblichen Deformierungen der Gelenke, die meist mit funktionellen Einschränkungen einhergehen. Die resultierenden somatischen, funktionellen und psychosozialen Folgen dieser chronischen Krankheit führen zu deutlichen Einschränkungen der Aktivität (Alltagsaktivitäten) und damit auch Teilhabe (Partizipation) am Leben in der Gesellschaft. Für die langfristige Prognose der Erkrankung ausschlaggebend ist die Verhinderung bzw. Verlangsamung von struktureller und radiologischer Gelenkdestruktion und damit einhergehend eingeschränkter Funktionen bzw. Funktionsverlust, die letztlich auch eine Verbesserung der gesundheitsbezogenen Lebensqualität zur Folge haben. Eine erfolgreiche ganzheitlich orientierte Therapie der RA ist immer eine multimodale Therapie, die neben der Pharmakotherapie immer auch nichtpharmakologische, insbesondere funktionsorientierte physikalische Therapieformen und psychosoziale Anwendungen sowie umfassende Rehabilitationsmaßnahmen erfordert, die idealerweise lebenslang begleitend zur medikamentösen Therapie zur Anwendung kommen. Ihre differenzialindikative Verordnung und aktuelle Evidenzlage der nonpharmakologischen Therapie ist Gegenstand dieser Übersicht.

Summary

Rheumatoid arthritis is a chronic condition that usually tends to progress towards morphological and functional deficits. Although pharmacological approaches can often significantly reduce symptoms of the disease and/or radiological progression, for many patients with RA disability, pain, psychological distress, fatigue impair their participation in normal life and reduce their health-related quality of life. Successful treatment of RA always involves non-pharmacological approaches such as physiotherapy, exercise training, psychological support, occupational therapy etc. in a multidisciplinary team. We provide an overview about the available spectrum of non-drug approaches, their indications in treatment strategies of RA as well as the current evidence.

Schlüsselwörter

Rheumatoide Arthritis - nichtpharmakologische Therapie - physikalische Therapie

Keywords

Rheumatoid arthritis - non-pharmacological approaches - physiotherapy

• Literatur

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