Clin Geriatr Med. 1993 Nov; 9(4): 783-801.
Rehabilitation of the elderly patient with arthritis.
University of Maryland School of Medicine, Baltimore.
The rehabilitation of an elderly patient with arthritis involves a cooperative effort on the part of patients and their caregivers, therapists, and physicians. If treatment is begun early in the course of the disease, the onset of functional decline and disability may be delayed or prevented. It may be useful for patients to contact the American Arthritis Foundation for further information and referral to support groups. Older people with arthritis must be included at a societal decision-making level in helping plan, design, and monitor community projects where handicap access questions arise. A major problem for people with disability is often the barriers they encounter in the environment and the attitudes of society. Treatment goals should be discussed and agreed on, and education and psychologic support should be provided for patients and their families. Each case must be individually assessed and a set of tailor-made rehabilitation interventions prescribed. Rest, exercise (active or passive), joint splinting, massage, heat (moist or dry heat), cold, pharmacotherapy, joint injection, surgery, and complementary treatment modalities such as homeopathy, acupuncture, education, and psychosocial support all have their role in the rehabilitation of the elderly patient with arthritis. For most patients, the course and prognosis are excellent. In general strength, ROM, and joint function can be preserved or improved to the point that participation in normal activities of daily living is possible.