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Arthritis : Occupational Therapy

General Information about Arthritis

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Arthritic Progression of Most Common Types

Although there are many different types of arthritis as described above. Osteoarthritis (OA) and Rheumatoid arthritis (RA) are the most common forms of arthritis and will therefore be discussed in this OT diagnosis profile.

 

Osteoarthritis

Process of OA [1]

  • The articular cartilage (lining that covers the ends of the bones) breaks down or wears away.
  • Cartilage (normally a rubbery and smooth-type surface) acts as a natural joint shock absorber. If the cartilage wears away, its ability to provide cushioning is also diminished.
  • As the cartilage wears away and the bones are exposed, the bones rub against one another.
  • Bone on bone irritation
  • Inflammation can occur secondary to the mechanical irritation of the involved joints.
  • The most common areas impacted are the distal interphalangeal joints, proximal interphalangeal joints, CMC joints in hand and MTP joints in feet.

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Evaluations and Progress Notes for Arthritis

(S) Subjective

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(O) Objective

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(A) Assessment

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(P) Plan

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General Treatment Ideas for Arthritis

Person

Therapeutic Exercise (strengthening, stretching)

  • PINCHING EXERCISES MAY BE CONTRAINDICATED AS REPETITIVE FINE MOTOR ACTIVITIES CAN EXACERBATE HAND JOINT SYMPTOMS CAUSING PAIN
  • AROM when possible, PROM in the event that mobility is difficult
  • Isometric exercises are preferred, Isotonic exercises may be performed if patient can tolerate it but do be cautious!
  • Low impact aerobics, stretching, flexibility, and endurance training is good (swimming is great!)

Education

  • Disease information, prognosis, and process
  • Potential symptoms and solutions
  • Joint protection
  • Energy Conservation training across multiple contexts
  • Task simplification
  • Fatigue management

 

 

Environment

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Occupation

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Research Approaches for Arthritis

Research Approach Ideas

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References

References
  •  

    • Atchison, B.J. and D.P. Dirette, Conditions in Occupational Therapy : Effect on Occupational Performance. fifth ed. 2017, Philadelphia, PA: Wolters Kluwer. 579.
    • Prioreschi, A., M. Tikly, and J.A. McVeigh, A three month controlled intervention of intermittent whole body vibration designed to improve functional ability and attenuate bone loss in patients with rheumatoid arthritis. BMC musculoskeletal disorders, 2014. 15(1): p. 403-403.
    • Hunter, D.J.M.P., J.J.B.P. McDougall, and F.J.P. Keefe, The Symptoms of Osteoarthritis and the Genesis of Pain. Rheumatic diseases clinics of North America, 2008. 34(3): p. 623-643.
    • Perneger, T.V., et al., Symptoms of osteoarthritis influence mental and physical health differently before and after joint replacement surgery: A prospective study. PloS one, 2019. 14(6): p. e0217912-e0217912.
    • Benz, T., et al., Association of the sense of coherence with physical and psychosocial health in the rehabilitation of osteoarthritis of the hip and knee: a prospective cohort study. BMC musculoskeletal disorders, 2013. 14(1): p. 159-159.