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Jarret G.1, Orpana A.1, Foss A.M.1
1Skogli Helse - og Rehabliteringssenter AS, Lillehammer, Norway
Background: Rehabilitation for people with rheumatic disorders (15 % of worldwide population) is a long term project. Rheumatic patients do not exercise as often as recommended. Intensive multidisciplinary interventions in rehabilitation-centers are in some countries an option - of which there is little effect knowledge. Perhaps data from a quality-management report can shed some preliminary light on this subject.
Purpose: Primarily to observe short and long term effects of a three weeks intensive multidisciplinary program for people with rheumatic disorders, and secondary to see if a correlation can be found between level of training frequency and levels of pain, stiffness, and self rated health.
Methods: 738 patients (age 62.0+11.1, 84% women), followed a three weeks multidisciplinary program of individual and group sessions - with physiotherapy as main focus - during the period of August 2010 to September 2016. 3-month follow-up: N=252 and 12-month follow-up: N=118. Data from self-reported questionnaires at T1-T4 was gathered. Paired sampled T-tests and Pearson product-moment correlation coefficients was used to analyze the data obtained, using IBM SPSS Statistics v.23.
Instruments:
o NRS-11 for pain and stiffness at baseline (T1), at discharge (T2), and at 3- (T3) and 12 months (T4) after discharge.
o Self-rated level of health at T1, T2, T3 and T4.
o Self-reported level of training frequency at T1, T3 and T4
Results: There was a clear mean improvement (p .0001) on all factors at T2 of moderate/large effect-size. At T3 there was a mean improvement (p .05) on all factors, except pain, of small/moderate effect size. There was a mean improvement (p .05) on self-rated level of health and training frequency at T4 of a small effect size. Worth noting is that the degree of stiffness and pain at T4 is back to T1-level.There was a correlation (p .05) between level of training frequency and self-rated level of health (small at T1/T3, medium at T4), but no correlation between level of training frequency and level of pain, or level of stiffness, at any time. This suggests that a higher training frequency is associated with a higher sense of health regardless of symptom levels.
Conclusion(s): People with rheumatic disorders seem to have a very positive short term effect on all aspects after a three week intensive multidisciplinary program, but gradually return to pre-rehab levels during the following year especially regarding symptoms like stiffness and pain. At the same time there seems to be a much slower decline in self-rated level of health especially for those who regularly exercise. Properly randomized controlled trials are however needed to be able to draw any clear conclusions.
Implications: There might be a need for intensive multidisciplinary programs for rheumatic patients at intervals of less than a year, to be able to better keep the general health and function gained. Another possible implication is to implement a more clear focus on teaching rheumatic patients the necessity for an active lifestyle including regular exercises for them to be able to maintain their sense of general health, regardless of symptom levels.
Funding acknowledgements: None
Topic: Rheumatology
Ethics approval: The data-gathering and analyses presented here is part of continuous quality-management and is approved by the Norwegian Data Protection Authority.
All authors, affiliations and abstracts have been published as submitted.
