Background/Purpose: Rheumatoid arthritis (RA) is an autoimmune condition that affects the synovial membrane of the joints and is often associated with pain, fatigue, deformity, and significant limitations in meaningful occupations. This can lead to difficulty in performing activities of daily living and work duties or loss of social participation and relationships. This systematic review examined intervention studies to determine the efficacy of occupational therapy related interventions for adults with rheumatoid arthritis: What is the effectiveness of interventions within the scope of occupational therapy practice on occupational performance (function), pain, fatigue, and depression in persons with rheumatoid arthritis? Methods: This systematic review evaluated intervention studies published from 2000-2014 identified from the Medline, PsycINFO, CINAHL, OTseeker, and Ergonomics Abstracts databases. Bibliographies from included articles and relevant journals were also hand searched. Inclusion criteria required interventions be within the scope of occupational therapy practice, studies be published in English and include adults with RA, and provide Levels I, II, or III evidence. Interventions focusing solely on the upper or lower extremities were not included. Remaining studies that met the inclusion criteria were divided into two general intervention themes, reviewed by teams, and rated on bias. The final analysis included 64 studies (25 physical activity and 39 psychoeducational interventions). Results: Strong evidence was found to support the use of aerobic exercise, resistive exercise, aquatic exercise, Tai Chi, and yoga. The results for dynamic exercise interventions were mixed. For the psychoeducational interventions, strong evidence was also found to support the use of patient education and self-management, cognitive-behavioral approaches, multidisciplinary approaches, and joint protection, while little or mixed evidence supported the use of assistive technology or emotional disclosure. Conclusion: While the evidence supports interventions within the scope of occupational therapy practice, few interventions could be done within the constraints of current health care delivery models.
Apodaca, Beverly; Melissa Watson; Janet Poole; and Patricia Siegel. "Effectiveness of Occupational Therapy Interventions for Adults with Rheumatoid Arthritis: An Evidence-Based Review." (2016). https://digitalrepository.unm.edu/ot/9