| Abstract | Reumatoidni artritis (RA) je kronična, upalna, sistemna i autoimuna bolest mezenhima tj. vezivnog tkiva u čitavu organizmu koja se najčešće javlja na perifernim zglobovima, a karakterizirana je fazama egzarcebacije te fazama remisije. Prisutna je još od davnina, a javlja se češće u žena nego kod muškaraca, u odnosu 3:1. U etiopatogenezi RA sudjeluje nekoliko mehanizama uključenih u upalnu kaskadu koja vodi do progresije i postojanja autoimune upale i u konačnici do ireverzibilnog oštećenja zglobnog tkiva. Iako je RA bolest nepoznate etiologije, smatra se da nasljeđe čini 60% u nastanku bolesti, a geni koji utječu na pojavnost i težinu bolesti su HLA DR4, HLA DR1 i HLA DR14. Osim nasljeđa važnu ulogu čine spol i čitav niz okolinskih čimbenika. Početak bolesti je uglavnom postupan, a prva karakteristična tegoba koja se javlja je jutarnja zakočenost malih zglobova šake u trajanju duže od sat vremena. Osim na zglobovima RA se može očitovati i na unutarnjih organima. Potrebno je da se pacijent što prije javi liječniku kako bi se postavila dijagnoza što ranije te kako bi se moglo što prije započeti s odgovarajućim liječenjem. U liječenju se koristi različita medikamentna terapija, fizikalna terapija i kineziterapija. Fizioterapeut ne može utjecati na aktualan tijek bolesti ili na genetske čimbenike, ali može smanjiti posljedice bolesti kao što je smanjena mišićna snaga i/ ili tolerancija na vježbu. To znači da fizioterapeut ima važnu ulogu u tijeku bolesti. Fizioterapeut pomaže pacijentu u procesu poboljšanja i/ili rješavanja problema vezano uz njegovo iskustvo ograničenja i restrikciju u aktivnostima svakodnevnog života korištenjem pomoćnih i kompenzacijskih strategija. Istraživanja su pokazala da 63% bolesnika s RA ujedno boluje i od psiholoških poremećaja, a kao uzrok se navode problemi i poteškoće koje su povezane s tijekom bolesti, te manjak socijalne podrške u procesu rehabilitacije. Naime kod bolesnika s RA s vremenom se javljaju deformiteti, pa u konačnici može doći i do invalidnosti, a sve to dovodi do toga da pacijent nije u stanju potpuno brinuti o sebi i obavljati sve aktivnosti koje život zahtijeva. Takvi pacijenti imaju poteškoća u međuljudskim odnosima i u radnoj okolini, pa sve to dovodi do pojave anksioznosti i depresije, stoga je vrlo važna podrška obitelji, ali i razgovor sa zdravstvenim djelatnicima te s ostalim pacijentima koji su u istoj situaciji. |
| Abstract (english) | Rheumatoid arthritis (RA) is a chronic, inflammatory, systemic and autoimmune disease of the mesenchyme, ie connective tissue in the whole organism, which most often occurs on peripheral joints, and is characterized by phases of exacerbation and phases of remission. It has been present since ancient times, and occurs more often in women than in men, in a ratio of 3: 1. Several mechanisms involved in the inflammatory cascade involved in the etiopathogenesis of RA lead to the progression and existence of autoimmune inflammation and ultimately to irreversible joint tissue damage. Although RA is a disease of unknown etiology, inheritance is thought to account for 60% in disease onset, and the genes that influence the incidence and severity of the disease are HLA DR4, HLA DR1, and HLA DR14. In addition to heredity, gender and a number of environmental factors play an important role. The onset of the disease is mostly gradual, and the first characteristic problem that occurs is the morning stiffness of the small joints of the hand for more than an hour. In addition to the joints, RA can also be manifested on the internal organs. It is necessary for the patient to contact the doctor as soon as possible in order to make a diagnosis as early as possible and so that appropriate treatment can be started as soon as possible. Various drug therapy, physical therapy and kinesitherapy are used in the treatment. A physiotherapist may not influence the current course of the disease or genetic factors, but may reduce the consequences of the disease such as reduced muscle strength and / or exercise tolerance. This means that the physiotherapist plays an important role in the course of the disease. The physiotherapist assists the patient in the process of improving and / or resolving problems related to his or her experience of limitation and restriction in daily life activities using supportive and compensatory strategies. Research has shown that 63% of patients with RA also suffer from psychological disorders, and the cause is the problems and difficulties associated with the course of the disease, and the lack of social support in the rehabilitation process. Namely, in patients with RA, deformities occur over time, and eventually disability can occur, all of which leads to the patient not being able to fully take care of himself and perform all the activities that life requires. Such patients have difficulties in interpersonal relationships and in the work environment, so all this leads to anxiety and depression, so it is very important to support family, but also to talk to health professionals and other patients who are in the same situation. |
