Features of rehabilitation of elderly and senile patients with inflammatory arthropathies

Authors:

Makarova Olga Vladimirovna – PhD in Medical sciences (Cand. Med. Sci.), Associate Professor of the Department of Therapy N 1 of the Albrecht Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: olgamak2012@mail.ru; https://orcid.org/0000-0002-1849-0648.

Stolov Sergey Valentinovich – Grand PhD in Medical sciences (Dr. Med. Sci), Assistant Professor, Head of the Department of Therapy N 1 of the Albrecht Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: sv100lov@gmail.com; https://orcid.org/0000-0002-3431-1224.

Rodionova Anna Yuryevna – PhD in Medical sciences (Cand. Med. Sci.), Associate Professor of the Department of Therapy N 1 of the Albrecht Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: a.rod84@mail.ru; https://orcid.org/0000-0002-0186-7621.

Pogoda Tatyana Evgenievna – Deputy Head of the Hospital for Medical Affairs, Hospital for War Veterans, 21 Narodnaya Street, 2 bldg, 193079 St. Petersburg, Russian Federation; e-mail: pogodate@gmail.com.

Annotation:

Introduction. Rehabilitation of elderly and senile patients is an urgent task of modern medicine due to the global trend towards population aging. Inflammatory arthropathies, primarily gout and rheumatoid arthritis, remain among the most common diseases in elderly patients.

Aim. To study the clinical course of gout and rheumatoid arthritis in elderly and senile patients that affect the effectiveness of rehabilitation.

Materials and methods. The study included 124 elderly and senile patients with inflammatory arthropathies: 69 patients with gout and rheumatoid arthritis (mean age 78 years), 55 patients with rheumatoid arthritis (mean age 80.3 years). The disease duration was more than 15 years. All patients received current basic therapy, symptomatic drugs.

Results. All patients had a high frequency of comorbid pathology, mainly in the cardiovascular and urinary systems. Gout and rheumatoid arthritis were characterized by a relatively slowly progressive course with low activity of the inflammatory process, without the involvement of new joints and the development of severe dysfunction of the joints. All patients had limitations in life activities in the form of limited ability to self-care and independent movement of I-III degrees, the severity of which somewhat decreased after rehabilitation procedures.

Discussion. The use of all possible rehabilitation measures allows improving some categories of life activities, although remaining within the same degree, in particular, the ability to self-care and independent movement, which increases functional independence, social adaptation in everyday life and is relevant for older patients. However, the presence of severe comorbid pathology is often a contraindication to non-drug rehabilitation methods in elderly patients, which limits the success of rehabilitation measures.

Conclusion. When developing rehabilitation programs for elderly patients with inflammatory arthropathies, it is necessary to take into account their high comorbidity. In the rehabilitation of elderly and senile patients with gout and rheumatoid arthritis, the leading role belongs to the medical aspect of rehabilitation, including drug therapy, as well as non-drug methods – physiotherapeutic techniques and exercise therapy, which are prescribed in the absence of contraindications and under careful medical supervision.

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