Joint Protection Principles: Difference between revisions
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== Techniques == | == Techniques == | ||
'''Planning''' | '''Planning''' | ||
*Think before starting can the work be more efficient? | *Think before starting can the work be more efficient? | ||
*Can things be reorganise? | *Can things be reorganise? | ||
*Can certain jobs be delegates, or done less frequently? | *Can certain jobs be delegates, or done less frequently? | ||
*‘do’ the work when you’re at your best | *‘do’ the work when you’re at your best | ||
<br> | |||
'''Pacing''' | |||
*Little and often | |||
*Little and often | |||
*Take regular breaks change position, stretch | *Take regular breaks change position, stretch | ||
*Mix heavy and light jobs | *Mix heavy and light jobs | ||
*Do harder/more tiring jobs when fresh<br> | *Do harder/more tiring jobs when fresh<br> | ||
<br> '''Respect for Pain''' | |||
'''Respect for Pain''' | |||
*Pain that lasts more than 2 hours indicates joint damage. | *Pain that lasts more than 2 hours indicates joint damage. | ||
| Line 45: | Line 45: | ||
*Limit activities which cause pain to last more than one hour after you have stopped the activity.<br> | *Limit activities which cause pain to last more than one hour after you have stopped the activity.<br> | ||
<br> | |||
'''Balance Activity and Rest''' | |||
*Rest before becoming tired. | |||
*Plan rest periods during longer or more difficult activities. | |||
*By resting 10 minutes during an activity, you will have more energy to continue.<br> | |||
<br> | |||
'''Maintain muscle strength and joint range of motion''' | '''Maintain muscle strength and joint range of motion''' | ||
*Achieve full range of each joint while performing daily activities. | *Achieve full range of each joint while performing daily activities. | ||
*Perform specific exercises and range-of-motion activities. | *Perform specific exercises and range-of-motion activities. | ||
*Loss of range of motion and strength = loss of function. | *Loss of range of motion and strength = loss of function. | ||
<br> | |||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 17:38, 5 December 2013
Original Editor - Venus Pagare
Top Contributors - Venus Pagare, Abbey Wright, Shaimaa Eldib and Admin
Introduction[edit | edit source]
- Functional ability is reduced in 60% of people with rheumatoid arthritis (RA) within the first five years from diagnosis, with 16% developing more severe functional disability and 44% following a remittingurelapsing course.[1]
- Within two years 50% experience difficulties in household tasks.[2]
- Women with RA can have on average only 40% of normal power and pinch grip within six months of diagnosis, even with early commencement of disease-modifying drugs (DMARDs).[3] This suggests therapy to help maintain hand function and independence should be provided early for those developing functional limitations.
- Joint protection is a self-management approach that aims to maintain functional ability through altering working methods and movement patterns of affected joints, using assistive devices and pacing activities. This helps reduce pain, inflammation and stresses applied to joints during daily activity and may help preserve the integrity of joint structures longer term.[4] [5]
- Rheumatology health professionals commonly teach joint protection. Focus is on changing hand habits, and increasingly people are referred earlier in the disease process for this education.
- Providing self-management information (such as joint protection advice) does not, on its own, lead to significant improvements in adherence or health status.[6] Behavioural approaches (i.e., skills practice, goal-setting and home programmes) are significantly more effective in increasing use of joint protection than ‘standard’ education (i.e., information, demonstration and short supervised practice) anduor information booklets.
- This approach is effective for people with both early (<5 years) [7] [8]and established RA (>/5 years).[9] [10]
Techniques[edit | edit source]
Planning
- Think before starting can the work be more efficient?
- Can things be reorganise?
- Can certain jobs be delegates, or done less frequently?
- ‘do’ the work when you’re at your best
Pacing
- Little and often
- Take regular breaks change position, stretch
- Mix heavy and light jobs
- Do harder/more tiring jobs when fresh
Respect for Pain
- Pain that lasts more than 2 hours indicates joint damage.
- Fear of pain results in inactivity and loss of motion and strength.
- Disregard for pain results in joint damage and pain.
- Stop activities before reaching the point of discomfort or pain.
- Limit activities which cause pain to last more than one hour after you have stopped the activity.
Balance Activity and Rest
- Rest before becoming tired.
- Plan rest periods during longer or more difficult activities.
- By resting 10 minutes during an activity, you will have more energy to continue.
Maintain muscle strength and joint range of motion
- Achieve full range of each joint while performing daily activities.
- Perform specific exercises and range-of-motion activities.
- Loss of range of motion and strength = loss of function.
References[edit | edit source]
- ↑ Young A, Dixey J, Cox Net al. How does functional ability in early rheumatoid arthritis (RA)affect patients and their lives? Results of 5 years of follow-up in 732 patients from the Early Rheumatoid Arthritis Study (ERAS)Rheumatology 2000;39: 603-11.
- ↑ Eberhardt KB, Rydgren LC, Petersson H, WollheimfckLRFA. Early rheumatoid arthritis- onset, course andfckLRoutcomes after two years.Rheumatol Int 1990;10:135-42.
- ↑ Hammond A, Kidao R, Young A. Hand impairment and function in early rheumatoid arthritis.Arthritis Rheum 2000;43(9 suppl):S285.
- ↑ Cordery J, Rocchi M. Joint protection and fatigue management. In: Melvin J, Jensen G eds. Rheumatologic rehabilitation, Volume 1:Assessment and management. Bethesda, MD: American Occupational Therapy Association, 1998: 279-322.
- ↑ Melvin J.Rheumatic disease: occupational therapy and rehabilitation, second edition. Philadelphia: FA Davis, 1989: 351-71
- ↑ Riemsma RP, Kirwan JR, Taal E, Rasker JJ. PatientfckLReducation for adults with rheumatoid arthritis(Cochrane review). In:The Cochrane Library, Issue 2. Oxford: Update Software, 2003.
- ↑ Hammond A, Freeman K. One year outcomes of afckLRrandomised controlled trial of an educational- behavioural joint protection programme for peoplefckLRwith rheumatoid arthritis.Rheumatology2001;40:1044-51.
- ↑ Brus HLM, van der Laar MAFJ, Taal E, Rasker JH. Effects of patient education on compliance with basic treatment regimens and health in recent onset active rheumatoid arthritis.Ann Rheum Dis 1998; 57: 146-51.
- ↑ Hammond A, Lincoln N, Sutcliffe L. A crossoverfckLRtrial evaluating an educational behavioural joint protection education programme for people with rheumatoid arthritis.Patient Educ CounsellingfckLR1999;37:19-32.
- ↑ Hammond A, Jeffreson P, Jones N, Gallagher J, Jones T. Clinical applicability of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Br J Occup Ther 2002;65: 405-12
