If rehabilitation aims to improve function, the demonstration of its effect
iveness requires functional assessment, rather than the standard clinical a
nd laboratory tests beloved of many rheumatologists. Medical interventions
are not often evaluated for their contribution to improved function, and th
is omission must be addressed in the future.
The evidence, where it is available, supports a multidisciplinary approach,
but increasingly stresses the importance of partnership with the patient,
passing back to them the responsibility for maintaining their own exercise
programmes and involvement in activities. However, the provision of backgro
und support appears to be essential to continued independence. Evidence for
the various interventions is reviewed.