Rheumatoid Arthritis

Question 1

What is Rheumatoid Arthritis?

Answer 1

A chronic autoimmune condition that causes redness, warmth, and swelling of joints.

Question 2

What is the pathology of RA?

Answer 2

• Disease process causes synovial tissue around joints to become inflamed.
• Joints become vulnerable and weak, and are at risk of damage and deformity through their use in everyday tasks.

Question 3

What are the symptoms of RA?

Answer 3

• Pain.
• Stiffness.
• Fatigue.
• Damage to the joint.
• Irritation.
• Inflammation.
• Swelling.
• Joint deformity.
• Limited joint ROM.

Question 4

What are the 3 main finger and hand deformities with RA?

Answer 4

1. Swan neck deformity.
2. Butonnieres Disease.
3. Ulnar deviation at MCPs and wrist joints.

Question 5

What is swan neck deformity?

Answer 5

Occurs when there is stretching of the extensor tendons on the back of hand, causing PIP to become hyperextended and rupture or laxity where extensor tendon attaches at DIP.

Question 6

What is Butonnieres Disease?

Answer 6

Person is unable to straighten finger- PIP flexed with DIP hyperextended.

Question 7

What is Ulnar Deviation?

Answer 7

At MCP joints- movement of fingers towards ulnar side of hand.

Question 8

What is role of OT with RA?

Answer 8

Assist them in managing their daily activities in ways
that protect their joints, manage pain, and cope with fatigue. This includes:
- Joint protection.
- Work simplification.
- Energy conservation.

Question 9

What is joint protection?

Answer 9

A series of techniques which reduce stress on joints, maintain function, prevent or reduce deformity, and can be included into the way all activities are done.

• Use larger, stronger joints, rather than put strain on smaller joints.
• Avoid grasp and pinch.
• Avoid repetitive and sustained postures or movements.
• Change position and keep moving.

Question 10

What is energy conservation?

Answer 10

Using your energy to accomplish a task in such as away that you still have energy to do other tasks.

Question 11

What are examples of energy conservation strategies?

Answer 11

• Plan a rest day or rest period after doing something strenuous.
• Take a break during activity to sustain energy longer.
• Joint pain- stop to avoid excessive pain and fatigue.
• Prioritise/plan activities to do when energy levels are higher and to minimise effort.
• Maintain proper posture so that joints are not strained.
• Change position regularly so not having to hold the one position for extended period of time.
• Stretch and relax joints during activity participation..

Question 12

What is work simplification?

Answer 12

Performance of tasks in the simplest way possible to conserve time and energy.

Question 13

What are examples of work simplification strategies?

Answer 13

• Organise workspaces and equipment for maximum efficiency (avoid lifting).
• Sit down to do tasks where possible.
• Storing items in containers that are easier to open/close.
• Organising environment so frequently used items are within easy reach.
• Sitting down to perform tasks.
• Slide items rather than lift.
• Using trolley rather then carrying items. Shallower to prevent reaching to collect and place items.