Patricia Siegel, Melissa Tencza, Beverly Apodaca, Janet L. Poole; Effectiveness of Occupational Therapy Interventions for Adults With Rheumatoid Arthritis: A Systematic Review. Am J Occup Ther 2016;71(1):7101180050. https://doi.org/10.5014/ajot.2017.023176
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© 2021 American Occupational Therapy Association
OBJECTIVE. We reviewed the efficacy of occupational therapy–related interventions for adults with rheumatoid arthritis.
METHOD. We examined 51 Level I studies (19 physical activity, 32 psychoeducational) published 2000–2014 and identified from five databases. Interventions that focused solely on the upper or lower extremities were not included.
RESULTS. Findings related to key outcomes (activities of daily living, ability, pain, fatigue, depression, self-efficacy, disease symptoms) are presented. Strong evidence supports the use of aerobic exercise, resistive exercise, and aquatic therapy. Mixed to limited evidence supports dynamic exercise, Tai Chi, and yoga. Among the psychoeducation interventions, strong evidence supports the use of patient education, self-management, cognitive–behavioral approaches, multidisciplinary approaches, and joint protection, and limited or mixed evidence supports the use of assistive technology and emotional disclosure.
CONCLUSION. The evidence supports interventions within the scope of occupational therapy practice for rheumatoid arthritis, but few interventions were occupation based.
Occupational therapy practitioners should be mindful of each person’s disease process and plan around both flare-ups and stable periods to make the most of interventions (Gaudin et al., 2008).
Strong evidence was found to support aerobic exercise, resistive exercise, and aquatic exercise as individual interventions for the reduction of pain, improvement of quality of life, and overall independence. Occupational therapy practitioners may incorporate exercise approaches such as coaching, home exercise, aquatic exercise, general strength training, or aerobic exercise.
Occupational therapy practitioners may use components of Tai Chi, yoga, or dynamic exercise programs to improve fatigue, depression, and vitality or recommend that clients participate in community-based programs.
Practitioners can use a variety of psychoeducational interventions such as general patient education, self-management, CBT, and individualized joint protection to improve function, pain, fatigue, depression, and self-efficacy.
Practitioners should keep in mind the outcome of self-efficacy to empower clients with RA. Even though laboratory measures of disease activity may not appear to change, improvements in self-efficacy may have positive effects on psychological status, function, and overall well-being.
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