A study on how to support the home-based exercise therapy for patients with rheumatoid arthritis

関節リウマチ患者の在宅運動療法支援の在り方の検討

A study on how to support the home-based exercise therapy for patients with rheumatoid arthritis

Degree Grantors Yamaguchi Prefectural University

Rheumatoid arthritis is a systemic inflammatory disease with chronic polyarthritis as the main symptom, and its treatment goal is to reduce disease activity as well as to suppress the progression of joint destruction. The purpose of this study is to investigate the ideal support for the home-based exercise therapy and also to clarify the current status of its implementation and the factors that cause its implementation.
Chapter 1 provides the background of this research, by discussing the symptoms and treatment of rheumatoid arthritis, the role of exercise therapy, the necessity of the home-based exercise therapy, and the support for patients with rheumatoid arthritis and other chronic diseases. Based on these findings, the purpose of this study was to clarify the current status of the home-based exercise therapy in patients with rheumatoid arthritis and the factors that implement it, and to examine the ideal way of support.
Chapter 2 describes a research study that clarifies the current status of the home-based exercise therapy for patients with rheumatoid arthritis. A questionnaire survey was conducted for rheumatoid arthritis patients living in one prefecture and the responses of 226 patients were analyzed. As a result, it was found that 35.4% of the patients knew that the home-based exercise therapy is recommended for patients with rheumatoid arthritis. On the other hand, 93.7% of patients thought that the home-based exercise therapy had a certain effect, and 91.4% of patients thought that the home-based exercise therapy was necessary. Thus, most patients had a high level of knowledge and interest in the home-based exercise therapy.
Chapter 3 describes a research study that clarifies the factors that affect the implementation of the home-based exercise therapy. A questionnaire survey was conducted for rheumatoid arthritis patients living in one prefecture and the answers obtained were divided into two groups, the group that underwent the home-based exercise therapy (n = 94) and the group that did not underwent it (n = 132). As a result of multivariate analysis, it was found that four factors significantly influenced the implementation of the home-based exercise therapy: age, occupation with a high degree of discretion, receiving injection treatment, and recommending the home-based exercise therapy by a doctor. It was also suggested that patients who were in pain or were not in remission were doing it according to their physical condition to the extent that it did not hurt.
Chapter 4 discusses the ideal way of support for the home-based exercise therapy by patients with rheumatoid arthritis. Based on the findings obtained in Chapters 2 and 3, the ideal way of support for the implementation of the home-based exercise therapy was discussed, focusing on three important perspectives: support for patient education, support for self-care, and support for multidisciplinary collaboration. Finally, based on the findings of this study, I concluded that it is important to provide support for patients with rheumatoid arthritis so that they can take the initiative in treating the home-based exercise therapy as an important way of self-care.

Creators Kamo Naoko