Cryotherapy for Rheumatoid Arthritis

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Cryotherapy for Rheumatoid Arthritis

The benefits of cryotherapy for people living with forms of arthritis, such as rheumatoid arthritis, can range from improved range of motion to reduction in pain and inflammation. Although results may vary, Cryotherapy has become a widely recognized treatment option for Rheumatoid Arthritis.

In fact, the development of cryotherapy in the 1970's began with a rheumatologist recognizing the benefit cryo principles had for his patients. 

Because rheumatoid arthritis is an autoimmune and chronic degenerative condition with no known cure. It is considered one of the most severe forms of arthritis and can lead to long-term joint damage and disability. For those suffering from this condition, Cryotherapy has become an alternate treatment method for reducing inflammation which can subsequently alleviate pain and discomfort. 

Cryotherapy Studies conducted for Rheumatoid Arthritis

STUDY: Cryotherapy in inflammatory rheumatic diseases: a systematic review
The aim of this article was to review current evidence about cryotherapy in inflammatory rheumatic diseases (therapeutic and biological effects). For therapeutic effects, we performed a systematic review (PubMed, EMBASE, Cochrane Library, LILACS databases, unpublished data) and selected studies including non-operated and non-infected arthritic patients treated with local cryotherapy or whole-body cryotherapy. By pooling 6 studies including 257 rheumatoid arthritis (RA) patients, we showed a significant decrease in pain visual analogic scale (mm) and 28-joint disease activity score after chronic cryotherapy in RA patients.
 
For molecular pathways, local cryotherapy induces an intrajoint temperature decrease, which might downregulate several mediators involved in joint inflammation and destruction (cytokines, cartilage-degrading enzymes, proangiogenic factors), but studies in RA are rare. Cryotherapy should be included in RA therapeutic strategies as an adjunct therapy, with potential corticosteroid and nonsteroidal anti-inflammatory drug dose-sparing effects. However, techniques and protocols should be more precisely defined in randomized controlled trials with stronger methodology.
To purchase the full study please click on the Taylor & Francis online reference link below.
Reference: Taylor & Francis Online
STUDY: Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?
Rehabilitation slows the progress of rheumatoid arthritis (RA) and prevents progression of disability. This study aimed to compare the impact of two rehabilitation programmes on pain, disease activity, locomotor function, global health and work ability forecast in RA patients. 
 
Materials and methods:
  • Sixty-four employed women aged 24–65 years participated in the study.
  • All patients underwent individual and instrumental kinesiotherapy.
  • Thirty-two patients underwent cryogenic chamber therapy and local cryotherapy as well as non-weight-bearing, instrumental and individual kinesiotherapy.
  • The remaining 32 patients received traditional rehabilitation in the form of electromagnetic and instrumental therapy, individual and pool-based non-weight-bearing kinesiotherapy.
  • Rehabilitation lasted 3 weeks. Patients were examined three times: prior to rehabilitation, after 3 weeks of therapy and 3 months after completion of rehabilitation.
 
The following study instruments were used:
  • To assess disease activity: DAS-28
  • Functional impairment: HAQ-DI
  • Pain severity: VAS
  • Patients’ overall well-being: a scale from 0 to 100 (Global Health Index)
  • Patients’ own prognosis of fitness for work: the 6th question from Work Ability Index (WAI).
 
Statistical analysis of data was performed using the STATISTICA 8.0 package. Mixed-design two-way analysis of variance was used for hypothesis testing. Results: All patients improved after rehabilitation.
 
The group of patients those who underwent cryotherapy had improved DAS-28, HAQ-DI, VAS and global health scores immediately following the 3-week rehabilitation program (p < 0.001, p = 0.001, p = 0.007 and p < 0.001, respectively), as well as at the 3-month follow-up (p < 0.001, p < 0.001, p = 0.009 and p < 0.001, respectively). Rehabilitation using cryotherapy resulted in greater improvement in disease activity DAS-28 [F(2,105) = 5.700; p = 0.007; η2 = 0.084] and HAQ-DI locomotor function scores [F(2,109) = 6.771; p = 0.003; η2 = 0.098] compared to traditional rehabilitation. The impact of both forms of rehabilitation on patients’ own prognosis of work ability in the next 2 years was not significant. Results of patients who underwent traditional approach showed decreased disease activity following the initial 3-week period; however, this improvement did not sustain to the end of follow-up, 3 months later. Conclusions: Complex rehabilitation in RA has a positive effect on patients’ clinical condition.
 
The rehabilitation program that includes cryotherapy overtops traditional rehabilitation, particularly as regards improvement in locomotor function, disease activity and sustaining willingness to continue working and exerts long-lasting effect.
  • Implications for Rehabilitation

  • Rehabilitation using cryotherapy is more effective in improving locomotor function, decreasing disease activity and sustaining willingness to continue working compared to traditional rehabilitation.

  • Rehabilitation using cryotherapy significantly reduces the intensity of pain experienced by patients with RA, and this positive effect is maintained at 3 months post-rehabilitation.

  • Complex rehabilitation, particularly treatment using cryotherapy, improves patients’ subjective assessment of their overall well-being and perception of their disease.

  • Complex rehabilitation in rheumatoid arthritis has a positive effect on patients’ clinical condition.

To purchase the full study please click on the Taylor & Francis online reference link below.
Reference: Taylor & Francis Online

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