爱康类风湿论坛

 找回密码
 快速注册

QQ登录

只需一步,快速开始

感谢那些曾经为论坛捐助的康友教你如何正规治疗类风湿性关节炎在线电子病历,记录生活每一天爱康之家会员公约,康友必读!
清除来氟米特用消胆安考来烯胺免费参与生物制剂临床治疗项目权威书籍《中华风湿病学》电子版类风湿关节炎治疗中的常见问题
12
返回列表 发新帖
楼主: 可乐加水

144-第144章 风湿病的康复治疗

[复制链接]
 楼主| 发表于 2008-11-20 09:13:56 | 显示全部楼层
友情提示:风趣爱康(www.iKang.org)是类风湿公益论坛,网友言论只代表本人观点,请大家文明发言!

144-10-第十节 职业咨询

就业也是关节炎患者康复的主要目的之一。患者是否能留在原来的工作岗位,乃取决于其功能状况、发病期限、是否接受药物或康复治疗、工作性质及雇主对于患者工作方式或工作环境调适空间的大小而定。若患者无法胜任原来的工作,则须再接受相关的训练才能改变职业。
回复

使用道具 举报

 楼主| 发表于 2008-11-20 09:14:21 | 显示全部楼层

144-11-第十一节 常见风湿病之康复原则

一、多发性关节炎急性期   
$ M7 B, T, H) i! |8 [  [! F6 p$ t, i7 Y% x
      此情况以类风湿关节炎的急性期为代表,患者可能有发热、全身倦怠、多处关节肿胀等现象。治疗首先要使患者获得充分的休息,必要时甚至要住院完全卧床休息。为了防止关节挛缩,可在治疗师的协助下,做主动辅助性关节运动,全身各大关节一天至少做几次全范围(fullrange)的关节运动。特别发炎肿胀的关节可使用冰敷或休息性副木以消肿、止痛;特别疼痛的部位也可用电刺激止痛。若急性期持续数天以上,为了防止肌肉萎缩,应以等长收缩来训练肌力,此时不宜使用等张或等速收缩。有些患者在肿胀关节附近的肌肉会痉挛、疼痛,可在肌肉上按摩、热敷或冰敷。
4 |4 F( O* }0 T- _  r0 @# Q7 f% I3 O- n% k8 e* x% Z' I' E2 H3 F4 j
   二、多发性关节炎之亚急性期及慢性期    ' D3 u3 O1 r! N* d

5 Q& H; N/ k8 _* @2 `  i6 C8 F      视患者的病情,休息的时间可逐渐减少,运动的时间逐渐增多。关节活动可由辅助性主动运动逐渐改为主动运动。若是有些关节已经挛缩或僵硬,可在热疗之后再加上关节或软组织的牵张运动。运动之后可再加上冷疗,或使用副木牵张关节或软组织。肌力强化运动可由等长收缩逐渐增加等张收缩运动。早期的运动也可由水中运动开始。若情况良好,则可逐渐加强心肺耐力训练,包括:水中运动、自行车运动、步行、有氧舞蹈、网球、高尔夫球及改良式的太极拳等。此时大部分关节已无发炎、肿胀现象,故冷疗可逐渐改为热疗,包括热敷、水疗、温泉疗法等。此外,患者需学习如何保护关节及如何节省体力。情况必要时,可使用手杖、拐杖、助行器及日常生活所需的各种辅具。足部疼痛、变形的患者,须选择合适的鞋子,并配制适当的鞋垫,以改善步态。
% g. Q3 s! u  l+ S7 a( W' T5 |% U; ~
   三、侵犯脊椎为主的关节炎
/ J/ c- ^  l8 U1 T* o+ ^
6 r, V/ L3 r: F* L! k3 J- L  p& W      代表性的疾病是强直性脊椎炎。患者除了背痛、颈痛、胸痛及他处关节疼痛之外,驼背会愈来愈厉害,躯体会愈来愈僵硬。若是侵犯髓关节,更会造成患者行动及日常生活(包括性生活)上诸多的困难。康复治疗最主要的是运动,颈椎、肩关节、舰关节每天须作全范围的关节运动;胸、腰椎须加强后仰运动,以防止询楼变形;胸肌、背肌、骸关节屈肌、膝关节屈肌等须加强牵张运动,以避免挛缩;背肌、腹肌及股四头肌须加强肌力训练。此外,呼吸训练可与胸肌之牵张运动合并进行。若患者情况良好,亦可从事各种心肺耐力训练。由于多数患者脊椎硬而脆,骨密度亦低,故应避免会直接碰撞的运动(如足球、橄榄球、篮球、柔道等),以避免脊椎骨折。背痛或其他部位的慢性疼痛可用热敷、电刺激、水疗或温泉浴来缓解。1 f9 l  U( B: c& r6 W3 b* ~
6 [# p/ @  ?3 g4 S
   四、下肢单一负重关节的病变    3 Y6 m1 T. }: P6 L3 `' p
3 ?! f, A) z, g) m" O
      风湿病(如骨关节炎)若侵犯膝或骸关节,常会造成患者行动的困难。治疗的原则是在急性期先用冰敷或电刺激止痛,亦可使用弹性护膝以防止肿胀(当然关节内积水要先抽出)。其次是适当的摆位及关节运动,以避免关节挛缩。为了防止肌肉萎缩,肌力训练可从等长收缩开始,再逐渐增加等张收缩。情况良好的患者,可建议心肺耐力训练,如游泳、自行车、低冲撞的有氧运动、网球、高尔夫球等。若患者在慢性期有关节挛缩的现象,则可使用水疗、热敷、超声波等再加上牵张运动。下肢疼痛的患者亦可在对侧以手杖支撑,以减少关节的负荷。若膝关节炎有内翻(varus)变形时,可在鞋垫加装外侧楔形突起(lateral wedge)以减轻内侧胫股关节(tibiofemoral joint)承受的压力。
' J. o1 v' j) K0 e1 l/ M2 w+ y* c                                                                                        ( 谢霖芬   周昌德  )
, S3 r2 b( o& `/ F* B0 W  w      参考文献:
: C; H( z" U2 M  c* y7 I6 d, p, K  i3 L9 H' W2 p
       Agudelo CA, Schumacher HR, Phelps P. Effect of exerciseon urate crystal一induced inflammation in canine joints. ArthritisRheum, 1972.15:609一616    Alexander GJM, Girtas C, Bacon PA. Bed rest, activity andthe inflammation of rheumatoid arthritis. Br J Rheumatol,1983.22:134一140    Aloia JF, Ccohn SH, Ostuni JA, Care C, Ellis K. Preven-tion of involutional bone loss by exercise. Ann Intern Med,1978.89:356一358    Althoff B, Goldie IF. Cervical collars in rheumatoid atlanto一axial subluxation: a radiographic comparison. Ann Rheum Dis,1980. 39:485一489    American Collage of Sports Medicine. AGSM' s guidelinesfor exercise testing and prescription. 6th ed. Philadelphia: Lip-pincott Williams&Wilkins. 2000    Ansell B. Pediatric rehabilitative rheumatology. In: Hicks J,Nicholas J, Swezey R,  editors.  Handbook of rehabilitativerheumatology. NY: Contact Associates; 1988. 167一183    Appell IU. Muscular atrophy following immobilization: a re-view. Sport Med,1990.10:42一48    Badley EM. The effect of osteoarthritis on disability andhealth care use in Canada. J Rheumatol ,22 suppl 1995.43:19一22    Banwell BF. Exercise and mobility in arthritis. Nuts ClinNorth Am, 1984. 19:605一616    Basford JR. The physical agents. In: Grabois M, GarrisonSJ, Hart KA, Lehmkuhl LD, editors. Physical medicine&reha-bilitaion: the complete approach. 1st ed. Malden: Blackwell Science, Inc;2000. 423一439    Beals CA, Lampman RM, Banwell F, et al. Measurementof exercise tolerance in patients with rheumatoid arthritis and os-teoarthritis. J Rheumato1,1985. 12:458一461    Benson TB, Copp EP. The effects of therapeutic forms ofheat and ice on the pain threshold of the normal shoulder.Rheumatol Rehabil, 1974.13.101一105    Biundo JJ,  Rush PJ.  Rehabilitation of patients withrheumatic diseases. In: Ruddy S, Harris ED, Sledge CB, BuddRC, Sergent JS, editors. Kelley's textbook of rheumatology.6th ed. Philadelphia; WB Saunders:2001. 763一775    Booth FW, Gollnick PD. Effects of disuse on the structureand function of skeletal muscle. Med Sci Sports Exer, 1983.15:415一420      Booth FW. Effects of limb immobilization in skeletal muscle.J Appl Physio1,1982. 52:1113一1118    Brassell MP. Sexuality. In: Riggs GK, Gall EP, editorsRheumatic diseases: rehabilitation and management.  1st ed.Boston: Butterworth Publishers; 1984. 329一339    Brattstr? m M.Joint protection and rehabilitation in chronicrheumatic disorders. 3rd ed. Frome: Wolfe Medical PublicationsLtd; 1987    Calin A, Garrett S, Whitelock H, et al. A new approach todefining functional ability in ankylosing spondylitis: the develop-ment of the Bath Ankylosing Spondylitis Functional Index. JRheumatol,1994. 21:2281一2285    Callahan LF, Brooks RH, Summey JA, Pincus T. Quanti-tative pain assessment for routine care of rheumatoid arthritis, us-ing a pain scale based on activities of daily living and a visual ana-log pain scale. Arthritis Rheum ,1987. 30:630一636    Chamberlain MA, Corbett M. Carpal tunnel syndrome inearly rheumatoid arthritis. Ann Rheum Dis,1970. 29:149一52    Constant F, Collin JF, Guillemin F, Boulange M. Effective-ness of spa therapy in chronic low back pain: a randomized clinicaltrial. J Rheumato1,1995. 22:1315一1320    Coughlin MJ. The rheumatoid foot一pathophysiology andtreatment of arthritic manifestations. Postgrad Med, 1984. 75:207一216    Curkovi B, Vituli V, Nagle D, et al. The influence of heatand cold on the pain threshold in rheumatoid arthritis. J Rheuma-tol,1993. 52:289一291    Danneskiold一Samsoe B, Lyngberg K, Risum T, TellengM. The effect of water exercise therapy given to patients withrheumatoid arthritis. Scand J Rehabil Med,1987.19:31一35    Davies GJ. A compendium of isokinetics in clinical usage.2nd ed. La Crosse: S&S Publishers. 1984    deLateur BJ, Lehman NJ, Stonebridge J, Warren CG. Iso  tonic versus isometric exercise: a double一shift transfer一of一  training study. Arch Phys Med Rehabi1,1972. 53:212一226      deLateur BJ, Lehman NJF, Fordyce WE. A test of the de-  Lorme axion. Arch Phys Med Rehabi1,1968. 49:245一248      Deyo RA, Walsh NE, Martin DC, et al. A controlled trial  of transcutaneous electric nerve stimulation (TENS) and exercise  for chronic low back pain. N Eng J Med,1990. 322:1627一1634      Dimonte P, Light H. Pathomechanics, gait deviations, and  treatment of the rheumatoid foot. Phys Therapy, 1982. 62:1148  一1156      Ekblom B, Lovgren O, Alderin M, et al. Effect of short一  term physical training on patients with rheumatoid arthritis. II.  Scand J Rheumato1,1975. 41:87一91      Elkayam O, Wigler 1, Tishler M, et al. Effect of spa thera-  py in Tiberias on patients with rheumatoid arthritis and os-  teoarthritis. J Rheumato1,1991.18:1799一1803      Fam AG. Spa treatment in arthritis: a rheumatologist’s  view (editorial).J Rheumatol,1991.18:1775一1777      Fisher SV, Bowar JF, Awad EA, et al. Cervical orthoses  effect on cervical spine motion: roentgenographic and goniometric  method of study. Arch Phys Med Rehabi1,1977. 58:109一115      Fries JF, Spitz P, Kraines RG, Holman HR. Measurementof patient outcome in arthritis. Arthritis Rheum, 1980. 23:137一  145      Furst G, Gerber L, Smith C. Rehabilitation through learn-ing: energy conservation and joint protection. Baltimore: Nation-al Institutes of Health. 1982      Gault SJ, Spyker JM. Beneficial effect of immobilization ofjoints in rheumatoid arthritides: a splint study using sequentialanalysis. Arthritis Rheum, 1969. 12:34一44      Gemignani G, Olivieri I, Ruju G. Transcutaneous electricalnerve stimulation on ankylosing spondylitis: a double blind study.Arthritis Rheum, 1985. 28:288一289      Gerber L, Hunt G. Ankle orthosis for rheumatoid disease.Arthritis Rheum, 1985.28:547      Gnootveld M, Henderson EB, Farrell A, et al. Oxidativedamage to hyaluronate and glucose in synovial fluid during exer-cise of the inflamed rheumatoid joint. Biochem J,1991. 273:459  一467    Goldberg VM, Kettelkamp DB, Colyer RA. Osteoarthritisof the knee. In: Moskowitz RW, Howell DS, Goldberg VM,Mankin ICJ, editors. Osteoarthritis: diagnosis and medical/sur-gical management. 2nd ed. Philadelphia: WB Saunders; 1992.P.599一620    Gordon D, Beastall GH, Thomson JA, Stklrrock.-Andro-genic status and sexual function in males with rheumatoid arthritisand ankylosing spondylitis. Q J Med,1986. 231:671一679           Gordon DA, Klinkhoff AV. Gold and penicillamine. In:  Ruddy S, Harris ED, Sledge CB, editors. Kelley's textbook of  rheumatology. 6th ed. Philadelphia: WB Saunders;.2001. P.  875一877      Granger CV. A conceptual model for functional assessment.  In: Granger CV, Gresham GE, editors. Functional assessment in  rehabilitation. Baltimore: Williams&Wilkins;1984. P.14一25      Gutin B, Kasper MJ.Can vigorous exercise play a role in os-  teoporosis prevention? A review. Osteoporosis Int,1992. 2:55一  69      Halar EM, Bell KR. Immobility: physiological and func-  tional changes and effects of inactivities on body functions. In:  Delisa JA, Gans BM, editors. Rehabilitaton medicine: principles  and practice. 3rd ed. Philadelphia: Lippincott一Raven Publish-  ers; 1998. P.1015一1034      Hall J, Skevington SM, Maddison PJ, Chapman K. A ran-  domized and controlled trial of hydrotherapy in rheumatoid arthri-  tis. Arthritis Care Res,1996. 9:206一215      Hamilton BB, Laughlin JA, Fiedler R, Granger CV. Inter-  ater reliability of the 7一level Functional Independence Measure  (FIM),Scan J Rehabil Med,1994. 26:115一119      Han JS, Sun SL. Differential release of enkephalin anddynorphin by low and high frequency electroacupuncture in the  central nervous system. Sci Intern J ,1990. 1:19一23      Harison RA.  Tolerance of pool therapy by ankylosingspondylitis patients with low vital capacities. Physiotherapy,  1981.67:296一297      Harris ED, McCroskery PA. The influence of temperatureand fibril stability on degradation of cartilage collagen by rheuma-toid synovial collagenase. N Engl J Med,1974-290: 1一6    Harris R, Copp EP. Immobilization of the knee joint inrheumatoid arthritis. Ann Rheum Dis,1962. 21:353一359    Hartman JT, Palumbo F, Hill BJ. Cineradiography of bracednormal cervical spine: comparative study of five commonly usedcervical orthoses. Clin Orthop,1975. 109:97一102    Herbert CA, Byrnes TJ, Baethge A, et al. Exercise limits-tion in patients with polymyositis. Chest, 1990.98:352一357    Herbison GJ, Jaweed MM, Ditunno JF. Muscle fiber atro-phy after cast immobilization in the rat. Arch Phys Med Rehabil,1978.59:301一305    Herbison GJ, Teng C, Martin JH, Ditunno JF. Carpal tun-nel syndrome in rheumatoid arthritis: a preliminary study. Am JPhysM记,1973. 52(2):68一74    Herman E, Willams R, Stratford P, Faras一Babjak, TrottM . A randomized controlled trial of transcutaneous electric nervestimulation (CODETRON) to determine its benefits in a rehabili-tation program for acute low back pain. Spine, 1994. 19:561一568    Hicks JE, Fromherz W, Miller F, et al. Cybex II strengthand endurance testing in normals and polymyositis patients [ Ab-stract].Arthritis Rheum, 31 Suppl 1988.4:559    Hicks JE, Gerber LH. Rehabilitation of the patient witharthritis and connective tissue disease. In: Delisa JA, Gans BM,editors. Rehabilitation medicine: principles and practice. 3rd ed.Philadelphia: Lippincott一Raven; 1998. P.1477一1516    Hochberg MC, Chang RW, Dwosh I, et al. The AmericanCollege of Rheumatology 1991 revised criteria for the classificationof global functional status in rheumatoid arthritis.  ArthritisRheum, 1992. 35:498一502    Hollander JL, Horvath SM. Changes in joint temperatureproduced by diseases and by physical therapy. Arch Phys Med,1949. 30:437一440    Hollander JL, Horvath SM. The influence of physical thera-py procedure on the intraarticular temperature of normal andarthritic subjects. Am J Med Sci,1949. 218:543一548    Horvath SM, Hollander JL. Intrearticular temperature as ameasure of joint reaction. J Clin Invest, 1949.28:469一473    Hsieh LF, Didenko B, Schmacher HR. Isokinetic and iso-metric testing of knee musculature in patients with rheumatoidarthritis with mild knee involvement. Arch Phys Med Rehabil,1987. 68:294一297    Huang MH, Diang HJ, Huang JF, Chai CJ, Yang RC. Ef-fects of sonification on articular cartilage of experimental os-teoarthritis in rats. J Rheumatol,1997. 24:1978一1984    Hughes VA, Frontera WR, Dallal GE, Lutz KJ, fisher EC,Evans WJ. Muscle strength and body composition: associationswith bone density in older subjects. Med Sci Sports Exerc,1995.27:967一974    Jan MH, Lai JS. The effects of physiotherapy on os-teoarthritic knees of females. J Formosan Med Assoc, 1991. 90:1008一1013    Jansson E, Sylven C, Arviddson 1, et al. Increase in myo-globin content and decrease in oxidative enzyme activities衍 legmuscle immobilization in man. Acta Physiol Scan, 1988.132:515一517    Jayson MIV, Dixon ASJ. Intraarticular pressure in rheuma-toid arthritis of the knee: pressure changes during joint use. AnnRheum Dis,1970.29:401一408    Johnson RM, Hart DL, Simmons EF, et al. Cervical or-thoses: a study comparing their effectiveness in restricting cervicalmotion in normal subjects. J Bone Joint Surg,1977. 59A: 332一339    Kane K, Taub A. A history of local electrical analgesia.Pain, 1975.1:125一128          Keenan MAE, Peabody TD, Gronley JK, Perry J. Valgusdeformities of the feet and characteristics of gait in patients whohave rheumatoid arthritis. J Bone Joint Surg, 1991. 73: 237一247    Kirby RL. Impairment, disability, and handicap. In: DelisaJA, Gans BM, editors. Rehabilitation medicine: principles andpractice. 3rd ed. Philadelphia: Lippincott一Raven; 1998. P.55一60    Klipper SE, Giannini MJ. Physical conditioning in childrenwith arthritis assessment and guidelines for exercise prescription.Arthritis Care Res 1994;7:226一236    Kohr WM, Snead DB, Slatopolsky E, Birge SJ Jr. Additiveeffects of weight一bearing exercise and estrogen on bone mineraldensity in older women. J Bone Miner Res, 1995. 10: 1303一1311    Kristein AE, Dietz F, Hwang SM. Evaluating the efficacyand potential use of a weight一bearing exercise, Tai一Chi Chaunfor rheumatoid arthritis patients. Am J Phys Med Rehabil,1991.70(3) :136一141    Lehmann IF, McMillan JA, Brunner GD, Blumberg JB.Compartive study of the efficiency of short一wave, microwaveand ultrasonic diathemy in heating the hip joint. Arch Phys MedRehabil,1959.40:510一512    Lehmann IF, Silverman DR, Baum BA, Kirk NL, JohnstonVC. Temperature distributions in the human thigh, produced byinfrared, hot pack and microwave applications. Arch Phys MedRehabi1,1966.47:291一299    Lequesne MG, Merry C, Samson M, Gerard P. Indexes ofseverity for osteoarthritis of the hip and knee. Scan J Rheumatol,suppl1987.65:85一89    Leventhal L, Ganjei A, Hirsch D, et al. Isokinetic strengthtraining in patients with rheumatoid arthritis [Abstract].Arthri-tis Rheum 1990.33 supple: 123    Lewis D, Lewis B, Sturrock RD. Transcutaneous electricalnerve stimulation in osteoarthritis: a therapeutic alternative? AnnRheum Dis,1984. 43:47一49    Liberson WT. Brief isometric exercises. In: Basmajian JV,editor.  Therapeutic exercise.  4th ed.  Baltimore:  Willams&Wilkins;1984. P.236一256    Lynberg KK, Ramsing BU, Nawrocke A. Safe and effectiveisokinetic knee extension training in rheumatoid arthritis. Arthri-tis Rheum, 1994. 37:623一629    Machover S, Sapecky AJ. Effect of isometric exercise on thequadriceps muscle in patients with rheumatoid arthritis. ArchPhys Med Rehabil, 1966. 47:737一741    Maillefert JF, Hudry C, Baron G, et al. Laterally elevatedwedged insole in the treatment of medial knee osteoarthritis: a prospective randomized controlled study. Osteoarthritis&Carti-lage,2001. 9(8):738一745      Malleson PN, Bennett SM, Kinnon MM, et al. Physicalfitness and its relationship to other indices of health status in chil-dren with chronic arthritis. J Rheumato1,1996. 23:1059一1065      Meenan RF, Gertman PM, Mason JH. Measuring healthstatus in arthritis. Arthritis Rheum, 1980. 23:146一152    Melzack R, Wall PD. Pain mechanism: a new theory. Sci-ence, 1965.150:971一978      Merritt JL, Hunder GG. Passive range of motion, not iso-metric exercise, amplifies acute urate synovitis. Arch Phys MedRehabi1,1983.64:130一131    Meyer CL, Hawley DJ. Characteristics of participants in wa-ter exercise programs compared to patients seen in a rheumaticdisease clinic. Arthritis Care Res,1994. 7:85一89    Mickelson J, Easley M, Wigley FM, Hellmann D. Foot andankle problems in RA. Foot Ankle Int,1994.15:608一613    Mills JA, Pinals RS, Ropes MW, Short CL, Sutcliffe J.Value of bed rest in patients with rheumatoid arthritis. N Engl JMed,1971.284:453一458    Minor M, Hewett J, Webel R, et al. Efficacy of physicalconditioning exercise in patients with RA and OA. ArthritisRheum, 1989. 32:1396一1405      Minor MA, Hewett JE, Webel RR, et al. Exercise toleranceand disease related measures in patients with rheumatoid arthritisand osteoarthritis. J Rheumato1,1988. 15:905一911    Minor MA, Hewett JE, Webel RS, Anderson SK, KayDR. Efficacy of physical conditioning exercise in patients withrheumatoid arthritis and osteoarthritis. Arthritis Rheum, 1989.32:1396一1405    Minor MA. Physical activity and management of arthritis.Ann Behav Med,1991.13(3):117一123    Moll JMH. Management of rheumatic disorders.  1st ed.London: Chapman and Hall Ltd. 1983    Moll JMH. Historical background. In Moll JMH, editor.Management of rheumatic disorders. 1st ed. London: Chapmanand Hall; 1983. P.1一32    Moritz U. Electromyographic studies in adult rheumatoidarthritis. Acta Rheum Scan, 1963. suppl 6:65    Mow VC, Sugalski MT. Physiology of synovial joints andarticular cartilage. In: Gonzalez EG, Myers SJ, Edelstein JE,Lieberman JS, Downey JA, editors. Physiological basis of reha-bilitation medicine. 3rd ed. Boston: Butterworth一Heinemann;2001. P.133一168    Muller EA. Influence of training and activity on musclestrength. Arch Phys Med Rehabi1,1970. 51:449一462    Nicholson CR, Daltroy L, Easton BSN, et al. Effects of aerobic conditioning in lupus fatigue: a pilot study. Br J Rheuma-to1,1989. 28:500一505      Nordemar R, Berg U, Ekblom B, Edstrom L. Changes inmuscle fiber size after physical performance in patients withrheumatoid arthritis after 7 months' physical training. Scan JRheumato1,1976. 5:233一238      Noreau L, Martineau H, Roy L, et al. Effects of a modifieddance一based exercise on cardiorespiratory fitness, psychologicalstate and health status of persons with rheumatoid arthritis. Am)Phys Med Rehabil,1995.74:19一27    O'Connell PG, Siegel KL, Kepple TM, Stanhope SJ, Ger-ber LH. Forefoot deformity, pain, and mobility in rheumatoidand nonarthritic subjects. J Rheumatol,1998.25:1681一1686    O'Grady M, Fletcher J, Ortiz S. Therapeutic and physicalfitness exercise prescription for older adults with joint disease: anevidence一based approach. Rheum Dis Clin North Am,2000.26(3):617一646    Paul Creamer. Osteoarthritis. In: Wall PD, Melzdck R, ed-itors. Textbook of Pain. 4th ed. London: Churchill Livingstone;1999.P.493一504    Rall LC, Meydani SN, Kehayias JJ, et al. Effect of pro-gressive resistance training in rheumatoid arthritis.  ArthritisRheum, 1996.39:415一426    Reisine S, Grady K, Goodenow C, Fifield J. Work disabili-ty among women with rheumatoid arthritis: the relative impor-tance of disease, social, work and family factors.  ArthritisRheum, 1989.32:539一543    Rishler M, Brostovski Y, Yaron M. Effect of spa therapy intiberias on patients with ankylosing spondylitis. Clin Rheumatol,1995.14:21一25    Ritchie DM, Boyle JA, McIness JM, et al. Clinical studieswith an articular index for the assessment of joint tenderness inpatients with rheumatoid arthritis. Q J Med,1968. 37:393一406    Rush P, Shore A. Physical modalities in the treatment ofmusculoskeletal disease. Br J Rheumatol,1994. 33-.566一568      Selkowitz DM. Electric currents. In Cameron MH, editor.Physical agents in rehabilitation. 1st ed. Philadelphia: WB Saun-ders;1999. P. 345一420    Sergent JS. Polyarteritis and related disorders. In: RuddyS, Harris ED, Sledge CB, editors. Kelley's texbook of rheuma-tology. 6th ed. Philadelphia: WB Saunders; 2001. P. 1185一1195    Sipski ML, Alexander C. Sexuality and disability. In: DelisaJA, Gans BM, editors. Rehabilitation medicine: principles andpractice. 3rd ed. Philadelphia: Lippincott一Raven Publishers;1998.P.1107一1129    Steinbrocker O, Traeger CH, Batterman RC. Therapeutic criteria in rheumatoid arthritis. JAMA,1949.140;659    Stillwell GK. Therapeutic electricity and ultraviolet radia-tion. Baltimore: Williams&Wilkins;1983    Stross JK, Mikkelsen WM. Educating patients with os-teoarthritis. J Rheumatol,1977.4:313一316    Sukenik S, Giryes H, Halevy S, et al. Treatment of psori-atic arthritis at the Dead Sea. J Rheumatol, 1994. 21:1305一1309    Swezey RL. Below一knee weight一bearing brace for thearthritic foot. Arch Phys Med Rehabil,1978.56:176一179    Swezey RL. Arthritis: rational therapy and rehabilitation.Philadelphia: WB Saunders;1978. P5    Tan J, Balci N, Sepici V, et al. Isokinetic and isometricstrength in osteoarthritis of the knee: a comparative study withhealthy women. Am J Phys Med Rehabil,1995. 74:364一9    Templeton MS, Booth DL, O' Kelly WD. Effects of aquatictherapy on joint flexibility and functional ability in subjects withrheumatic disease. J Orthop Sport Phys Ther, ,1996. 23 (6) :376一381    Tod EM. Massage and medical gymnastics. 4th ed. Lon-don: JMA Churchill Ltd Vainio K. 1956. The rheumatoid foot,a clinical study with pathological and roentgenological comments.Am Clin Gynaecol,1951.45 Suppl 1:1一40    Van den Ende CHM, Breedveld FC, le cessie S, et al. Effectof intensive exercise on patients with active rheumatoid arthritis:a randomized clinical trial. Ann Rheum Dis,2000.59:615一621    Verbrugge LM, Lepkowski JM, Konkol LL. Levels of dis-ability among U. S. adults with arthritis. J gerontol, 1991.46Suppl: 71一83    Vidigal EC. Forefoot in chronic rheumatoid arthritis. Orthop Rev,1978.7:43一46    Vignos P, Parker W, Thompson H. Evaluation of clinic ed-ucation program for patients with rheumatoid arthritis.  JRheumatol,1976. 3 :155一165    Walker JM. The historical record: paleopathology and physi-cal therapy in management o# arthritis. In: Walker JM, HelewaA, editors. Physical therapy in arthritis. 1st ed. Philadelphia:WB Saunders;1996.1一7    Weinberger A, Abramonvici A, Fadila R, Levy A, Giler S,Lev A. The effect of local deep microwave hyperthermia on exper-imental zymosaninduced arthritis in rabbits. Am J Phys Med,1990.69:239一244    Weinberger A, Fadilah R, Lev A, Shohami E, Pinkhas J.Treatment of articular effusions with local deep microwave hyper-thermia. Clin Rheumatol,1989.8:461一466    Westby MD. A health professional' s guide to exercise pre-scription for people with arthritis: a review of aerobic fitness ac-tivities. Arthritis Care Res,2001.45:501一511    World Health Organization. International classification of im-pairments, disabilities, and handicaps: a manual of classificationrelating to the consequences of disease. Geneva: World HealthOrganization. 1980    Yelin E, Henke C, Epstein W. The work dynamics of theperson with rheumatoid arthritis. Arthritis Rheum, 1987. 30:507一512    Yelin E, Meenan R, Neritt M. Work disability in rheuma-toid arthritis: effect of disease, social and work factors. Ann In-tern Med,1980.93:551一556    Yoshino S. Sexual problems of women with rheumatoidarthritis. Arch P场s Med Rehabi1,1981.62:122一123
回复

使用道具 举报

您需要登录后才可以回帖 登录 | 快速注册

本版积分规则

QQ|Archiver|手机版|小黑屋|爱康类风湿论坛 ( 桂ICP备12003771号 )

GMT+8, 2024-11-23 00:55

Powered by Discuz! X3.4

© 2001-2017 Comsenz Inc.

快速回复 返回顶部 返回列表