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Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).
Types of Musculo-Skeletal disorders in elder(2)
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
7. Low back pain
Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs) affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).
The aim of treatment is to stop the progression and relieve the symptoms of the diseases
1. Non Medication
1.1. Physical therapy
Relaxation and temperature biofeedback training as an adjunctive therapy has showed to alleviate both pain and stress-related symptoms as well as improvement of pain, tension, and sleep patterns. In fact, the therapy are found to induced higher physical/functional indices in comparison to physical therapy(174). Dr. Astin JA. and the research team at the University of Maryland School of Medicine suggested that psychological interventions such as relaxation, biofeedback, cognitive-behavioral therapy, may form an important part in may be important adjunctive therapies in the medical management of RA, especially for patients who have had the illness for shorter duration(175).In fact, a systematic review and meta-analysis of randomized controlled trials, also showed that psychological intervention improved both depressive symptoms and anxiety among patients with RA(176).
Low level laser therapy may be beneficiary in modulated inflammatory response both in early as well as in late progression stages of RA, through its effects in significantly improved mononuclear inflammatory cells(177) as well as modulating inflammatory mediators (IL-1β, IL-6)(178). The study of 132 patients at the age varying from 18 to 85 years presenting with rheumatoid arthritis by Dr.Kulova LA, and Dr. Burduli NM also found thatn the therapy showed an improvement of the endothelial function and the microcirculation indices in patient with rheumatoid arthritis(179). But according to a randomized double-blind controlled trial laser therapy using low-level aluminum gallium arsenide was not effective at the wavelength, dosage, and power studied for the treatment of hands among patients with rheumatoid arthritis(180).
1.4. Occupational therapy
According to the Canadian association of occupation therapy, it is form of treatment to solve the problems that interfere with your ability to do the things that are important to you. It can also prevent a problem or minimize its effects(181). According to the Netherlands Institute for Health Services Research, in controlled (randomized and non-randomized) and other than controlled studies (OD) addressing OT for RA patients showed that occupation therapy improved outcome on functional ability, social participation and/or health related quality of life(182). Rheumatologically, occupation therapy in many cases has successfully improved and maintained functional capacity, prevented progression of deformities, ......... of that may require for the engagement of the individual in meaningful occupations, favoring autonomy and independence in self-care activities, employment, educational, social and leisure(183)
Prosorba column apheresis therapy (PCT), a medical device containnig purified staphylococcal protein A covalently bound to a silica matrix has been used in many medical centers for treatment severerheumatoid arthritis (RA) since its approval in 1999(184) with some promising result(185).
The therapy showed a 52% improvement in joint tenderness, 40% improvement in swelling, 42% improvement in patient's pain, 38% improvement in patient's global response, and 48% improvement in physician's global scores 76% of responders, according to the study by Cypress Bioscience(184).
Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies
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(1) 8 Areas of Age-Related Change(NIH)
(2) Arthritis-Related Statistics(CDC)
(3) Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis by Keenan MA1, Peabody TD, Gronley JK, Perry J.(PubMed)
(4) Serum Sclerostin Level Among Egyptian Rheumatoid Arthritis Patients: Relation to Disease Activity ,Bone Mineral Density and Radiological Grading by Mehaney DA, Eissa M, Anwar S, El-Din SF(PubMed)
(4a) Death rates and causes of death in patients with rheumatoid arthritis: a population-based study by Sihvonen S1, Korpela M, Laippala P, Mustonen J, Pasternack A(PubMed)
(175) Psychological interventions for rheumatoid arthritis: a meta-analysis of randomized controlled trials by Astin JA1, Beckner W, Soeken K, Hochberg MC, Berman B.(PubMed)
(176) Psychological interventions for rheumatoid arthritis: examining the role of self-regulation with a systematic review and meta-analysis of randomized controlled trials by Knittle K1, Maes S, de Gucht V.(PubMed)
(177) Low-level laser therapy in different stages of rheumatoid arthritis: a histological study by Alves AC1, de Carvalho PT, Parente M, Xavier M, Frigo L, Aimbire F, Leal Junior EC, Albertini R.(PubMed)
(178) Effect of low-level laser therapy on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation by Alves AC, Vieira R, Leal-Junior E, dos Santos S, Ligeiro AP, Albertini R, Junior J, de Carvalho P.(PubMed)
(179) [The influence of intravenous laser therapy on the endothelial function and the state of microcirculation in the patients presenting with rheumatoid arthritis].[Article in Russian] by Kulova LA, Burduli NM.(PubMed)
(180) Assessment of the effectiveness of low-level laser therapy on the hands of patients with rheumatoid arthritis: a randomized double-blind controlled trial by Meireles SM1, Jones A, Jennings F, Suda AL, Parizotto NA, Natour J.(PubMed)
(181) What is occupation therapy(Canadian association of occupation therapy)
(182) Occupational therapy for rheumatoid arthritis by Steultjens EM1, Dekker J, Bouter LM, van Schaardenburg D, van Kuyk MA, van den Ende CH.(PubMed)
(183) [Occupational therapy in rheumatoid arthritis: what rheumatologists need to know?].[Article in Portuguese] by de Almeida PH1, Pontes TB2, Matheus JP2, Muniz LF3, da Mota LM3.(PubMed)
(184) Effects of Prosorba column apheresis in patients with chronic refractory rheumatoid arthritis by