Clinical Disease Activity and Power Doppler Changes Observed During a Multimodal Rehabilitation Program in Rheumatoid Arthritis: A Retrospective Longitudinal Observational Study
Year: 2026
Type: article
Abstract: Background/Objectives: Rehabilitation in active rheumatoid arthritis (RA) remains challenging, particularly regarding the dosing of physical agent modalities during in-flammatory activity. We evaluated changes in clinical disease activity, inflammatory markers, and Power Doppler (PD) activity in patients with RA undergoing individual-ized multimodal rehabilitation. Methods: In this retrospective longitudinal study, 29 patients with RA were assessed at baseline and after 8 weeks. The program comprised 10 supervised sessions of individualized electrotherapy and therapeutic exercise over 2 weeks, followed by 6 weeks of home-based exercise. Background disease-modifying an-tirheumatic therapy was unchanged; 16 patients received ESR-guided methylpredni-solone. Outcomes included DAS28-ESR and its components, C-reactive protein (CRP), and patient-level PD grade across a standardized joint set. Results: DAS28-ESR de-creased from 6.05 ± 0.87 to 4.03 ± 0.82, with significant reductions in all its components and in CRP (all p < 0.001). PD grade decreased from 2.38 ± 0.62 to 1.69 ± 0.66 (p < 0.001); 18 patients (62.1%) improved and none worsened. Changes in DAS28-ESR and PD grade were not correlated (ρ = 0.181, p = 0.348). In the 13 patients without gluco-corticoids, DAS28-ESR decreased from 5.22 to 3.41 (p < 0.001) and PD grade from 2.38 to 1.77 (p = 0.016). Conclusions: Improvements across clinical, laboratory, and ultra-sound domains were observed during individualized rehabilitation delivered along-side pharmacological treatment, while the magnitude of clinical and ultrasound changes was not significantly correlated. Because of the uncontrolled design and con-comitant glucocorticoid and NSAID therapy, the contribution of rehabilitation cannot be isolated; controlled studies of dose-adapted rehabilitation in active RA, prescribed by the rehabilitation physician in collaboration with the rheumatologist, are warranted.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm15208117
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7213461194