Integrating Rehabilitation Services into Routine Care of Rheumatoid Arthritis May Reduce the Inflammatory Response: A...

Background and Objectives: For persons with rheumatoid arthritis (RA), the accompanying systemic inflammatory conditions often insidiously damage extra-glandular organs, causing poor outcomes. Despite evidence manifesting the application of rehabilitation services (RSs), the association between RSs use and changes in the inflammatory response among persons with RA has not yet been established. With that in mind, this study aimed to evaluate changes in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) before and after long-term RSs use. Materials and Methods: For this two-group pre and posttest study, medical data of 4505 persons with RA aged 20-70 years between 2012 and 2017 were retrieved from an electronic medical record database held by a hospital in Taiwan. Of them, 1387 subjects were categorized as RSs users, who received RSs at least six times within the first year of RA onset. Generalized estimating equations analysis was then employed to compare the changes in ESR and CRP at baseline, and at 12, 18, 24, 30, and 36 months after RA onset. Results: After adjusting for inherent differences and mature impact, those receiving standard care plus RSs were found to have a lower CRP level than those without receiving RSs. This benefit was maintained within a 3-year follow-up period. Additionally, a slight but nonsignificant reduction in ESR existed over the same timeframe. Conclusions: Integrating RSs into conventional care may be helpful to modulate the inflammation for RA patients, but further research via randomized controlled trials is needed to validate the application of RSs.