| Sažetak | Klasifikacija reumatskih bolesti poznata pod nazivom „reumatizam“ obuhvaća više različitih bolesti. Reumatoidni artritis (RA ) je oblik artritisa koji uzrokuje bol, oteklinu, ukočenost i gubitak funkcije u zglobovima. To je kronična, sustavna upalna bolest koju karakterizira uništavanje sinovijalne membrane što rezultira destrukcijom, ankilozom i deformitetom. Reumatoidni artritis obično se ponavlja u epizodama koje traju po nekoliko tjedana ili mjeseci što se izmjenjuje s razdobljima u kojima uglavnom nema simptoma. Odlikuje se fazama spontanih remisija i egzarcebacijama. Bolest se javlja kao simetrični poliartritis, koji obično počinje periferno te se širi proksimalno, npr. na ruci zahvaća prvo proksimalne zglobove prstiju šake, zatim zahvaća ručni zglob, lakat, a tek u poodmaklom stadiju zglob ramena. Klinička slika je u početku bolesti obično nekarakteristična i vrlo varijabilna. Tada vodeći simptomi mogu biti gubitak apetita, bol u mišićima, anemija i ubrzana sedimentacija eritrocita. Nakon početne nespecifične faze pojavljuju se prvi karakteristični znakovi bolesti, kao što je jutarnja ukočenost zglobova, a najprije zglobova prstiju i šake. Postupci u bolesnika s aktivnim reumatoidnim artritisom obično počinju temeljitom procjenom svih tegoba bolesnika, fizikalnim pregledom i labaratorijskim testovima. Rutinska rentgenološka pretraga ključna je za dijagnozu i liječenje reumatskih bolesnika. Rendgenske snimke prikazuju oštećenja kosti i deformacije, te mogu pokazati koliko je bolest uznapredovala. Rehabilitacija bolesnika s upalnim reumatizmom, uz liječenje lijekovima, ima za cilj očuvanje punog ili funkcionalnog opsega pokreta svih zglobova, dostatne mišićne snage, uz toleranciju dnevnih opterećenja bez ili s podnošljivim bolom. Glavne sastavnice specijaliziranog rehabilitacijskog programa bolesnika s upalnim reumatizmom su procedure fizikalne terapije (medicinske vježbe, prilagođena fizička aktivnost, procedure termoterapije i elektroterapije, balneoterapija i masaža); promoviranje zaštite zglobova; korištenje pomagala i ortoza; edukacija i samopomoć bolesnika; redukcija tjelesne težine i vokacijska rehabilitacija. Jedna od najbitnijih stavki u skrbi o bolesniku oboljelom od reumatske bolesti svakako je edukacija. Potrebna je ne samo oboljelom, nego i članovima obitelji i svrha joj je pomoć u razumijevanju bolesti, važnosti svih mjera liječenja i njihovu svakodnevnom provođenju. |
| Sažetak (engleski) | Classification of rheumatic diseases known by the term „rheumatism “includes various diseases. Rheumatoid arthritis (RA) is a type of arthritis that causes pain, swelling, angularity and loss of articulation function. That is a chronicle, systematic disease that is characterised by destruction of synovial membranes, which results in destruction, anchylosis and deformation. Rheumatoid arthritis is usually repeated in episodes that can last from a few weeks up to a few months and is intertwined with periods in which, usually, there are no symptoms. It is characterised with phases of spontaneous remissions and exacerbations. This disease occurs as symmetrical polyarthritis, which usually begins peripherally and it spreads proximally, for example on arms it firstly affects proximal interphalangeal joints of the hand, and then it affects the wrist itself, elbow and in further stage it affects shoulder joints. In the beginning, clinical picture is usually uncharacteristic and very variable. Then the leading symptoms might be the loss of appetite, muscle pain, anaemia and accelerated erythrocyte sedimentation rate. Afterwards the first nonspecific phase, the first characteristic signs of disease, such as morning angularity of joints, finger joints and wrists, start to occur. Methods of treatment for patients with RA start with thorough assessment of all difficulties the patient is having, physical examination and laboratory tests. Routine of x-ray examination is crucial for setting the diagnose and hospital treatment of RA. The X-rays show bone damage and deformation, and can also show the extent of the disease. Rehabilitation of patients with inflammatory rheumatism, besides medication, has a goal of keeping full or functional extent of all joint movements, sufficiently muscle strength, with tolerance of daily ballast with or without tolerable pain. Principal components of specialised rehabilitation programme of patients with inflammatory rheumatism are procedures of physical therapy (medical exercises, adjusted physical activity, procedures of thermotherapy and electrotherapy, balneotherapy and massage); promoting joints protection; using orthopaedic aids and orthosis; education and self-help, reduction of body weight and vocational rehabilitation. One of the most important components in taking care of the patient with RA surely is education. It is necessary not only for the patient, but for the whole family. The aim of education is to help to understand the disease, to learn about the importance of all treatment procedures and about the importance of practicing new learned procedures as a daily routine. |
