Zusammenfassung
Die rheumatoide Arthritis (RA) ist eine chronische, entzündliche Gelenkerkrankung,
welche mit Gelenkschmerz, -schwellung und -destruktion einhergeht. Neben genetischen
Faktoren scheint auch der Lebensstil des Betroffenen einen Einfluss auf die Entstehung
der Krankheit zu haben. Da die Klassifizierung mithilfe der klassischen ACR-Kriterien
(ACR: American College of Rheumatology) nur für chronifizierte Formen der RA geeignet,
allerdings eine möglichst frühzeitige medikamentöse Therapie das Ziel ist, wurden
nun speziell zur Klassifizierung der Früharthritis die neuen ACR- / EULAR-Klassifikationskriterien
(EULAR: European League Against Rheumatism) entwickelt. Die krankheitsspezifische
Medikation hat sich sehr verbessert; dennoch sind Patienten, die an einer RA leiden,
infolge der chronischen Entzündungen häufig in den Bereichen körperliche Struktur
und Funktion, Aktivitäten und Partizipation eingeschränkt. Mittels der internationalen
Klassifizierung der funktionalen Gesundheit (ICF) können diese Probleme des Betroffenen
erfasst werden. Dies ist Voraussetzung für eine komplexe, durch ein multidisziplinäres
Team durchgeführte, Rehabilitation. Die therapeutischen Ansätze der Rehabilitation
umfassen die Übungs- und Trainingstherapie, Ergotherapie, physikalische Modalitäten,
psychologische Betreuung und diätische Maßnahmen. Ein solches Rehabilitationsprogramm
sollte individuell angepasst werden, um die Funktion und Selbstständigkeit des Patienten
möglichst lange zu erhalten.
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterised by joint
swelling, joint tenderness and joint destruction, leading to severe disability and
premature mortality. RA is considered an autoimmune disease, however, lifestyle factors
also influence the clinical manifestation of the disease. The ACR (American College
of Rheumatology)-classification criteria have a significant limitation in discriminating
patients suffering of early RA. To be able to treat these patients as soon as possible,
the new ACR / EULAR- (European League Against Rheumatism-) classification criteria
were developed. Despite medical treatment RA-patients often have deficits in body
structure and function, activities, and participation. The international classification
of functioning, disability and health (ICF) comprehensive core set for rheumatoid
arthritis helps to assess patients’ daily functioning and to plan a complex rehabilitation
performed by a multidisciplinary team. Non-pharmacologic therapeutic options include
exercise, occupational therapy, different physical modalities, psychologic care, and
special diets. Such a rehabilitation program has to be individualised to optimise
the effect and to conserve the patient’s function and independence as long as possible.
Schlüsselwörter
rheumatoide Arthritis - Rehabilitation - krankheitsspezifische Medikation - Übungs-
und Trainingstherapie - physikalisch-therapeutische Modalitäten
Keywords
rheumatoid arthritis - rehabilitation - disease-specific medication - exercise - physical
modalities
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Univ.-Prof. Dr. Katharina Kerschan-Schindl
Universitätsklinik für Physikalische Medizin und Rehabilitation, MUW, AKH Wien
Währinger Gürtel 18–20
1090 Wien, Österreich
Email: Katharina.Kerschan-Schindl@meduniwien.ac.at
