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Rheumatoid arthritis

Autoimmune disorder that primarily affects the joints but may affect major orga

RA is characterized by:

morning stiffness and Symmetrical polyarticular joint pain and inflammation of synovial membrane

stage 1 of RA

no destructive changes

stage 2 of RA

osteoporosis, no joint deformity, mm atrophy

stage 3 of RA

Severe, bone, joint, and mm changes

stage 4 of RA

fibrous or bony ankylosis

common affected joints of RA

MCP, PIP, DIP, metatarsalphalangeal joints, wrists, elbows, knees, hip, shoulders, thumb

Hand deformities for RA include

swelling, redness, heat, subluxation, crepitus, rheumatoid nodules, ulnar drift, swan neck deformities, boutonniere deformities, thumb deformities, rheumatoid nodules


bones not meeting where they are supposed to

Evaluations of RA include

visual inspection for deformities, MMT, grip strength, pain, ROM, joint laxity, composite motion, hand function tests, sensation

jebsen-taylor test

hand function

treatment for RA includes

joint protection, energy conservation, AROM, positioning, assistive devices, physical agents, resistive exercises

Exercises for RA include

increase joint range and muscle strength (depending on stage of disease), avoid stress, pain, and work within comfortable ROM, AROM preferred

joint protection

pain reduction for prevention, respect pain, strength and ROM, using joint in its most stable anatomical position, avoid deformity positions, using strongest joints, use correct patterns of motion, avoid staying in one position, avoid activities that cannot be stopped, balance and activity, reduce the force

types of splints for RA include

ulnar drift splint, RHS, figure 8 splints, thumb spica splint


damage to articular cartilage and bone

Osteoarthritis is due to

repetitive impact to joint

OA affects

knees, hips, thumb, spine, DIP

Treatment for OA include

Joint protection, reduction of excessive load, pain avoidance, environment modification, provide assistive devices

Energy conservation

proper body positioning (use joints symmetrically is possiblt), good body mechanics, avoid fatigue

Systemic Lupus Erythematosus (SLE)

systemic inflammatory disease characterized by small vessel vasculitis

SLE is characterized by

fever, rash, alopecia, pericarditis, Raynaud's phenomenon, pleurisy, nephritis

Progressive Systemic Sclerosis


progressive systemic sclerosis

generalized disorder of the connective tissues, characterized by fibrosis and thickening of the skin and internal organs (can be fatal)

Progressive systemic sclerosis affects

alimentary tract, synovium, heart, kidneys, tightening of the skin, Raynauds phenomenon

Ankylosing spondylitis

inflammation of sacroiliac, spinal apopyseal, and sternal joints


Presence of sodium urate crystals in the synovial fluid or deposits of urate crystals in or about the joints

4 P's

Pacing, Planning, Prioritize, Positioning


adequate rest (10 min per every hour of work), alternate activities, resist the temptation to overdue, stop before you get too tired


consider the best time of the day, make a schedule, allow enough time, plan what is to be done


Assertiveness, put first things first, eliminate, modify, and delegate

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