A RANDOMIZED CONTROLLED TRIAL TO EVALUATE THE EFFICACY OF COMMUNITY-BASED PHYSICAL THERAPY IN THE TREATMENT OF PEOPLE WITH RHEUMATOID-ARTHRITIS

Objective. To evaluate the short term efficacy of a community based ph ysical therapy (PT) program for people with rheumatoid arthritis (RA) through a single blind randomized controlled trial. Methods. Adults wi th active RA were referred by their physician for community based PT. Participants were randomized to either an immediate intervention group [experimental group (EG)] or a wait list control group (CG). The inte rvention was a standardized program of education and exercise consisti ng of at least 4 visits or 3 h of PT over 6 weeks. Baseline, 6, and 12 week assess ments were by a blinded independent assessor. The primary outcome instrument was the Stanford Arthritis Self-Efficacy Scale (SE S) and secondary outcome measures included the ACREU Rheumatoid Arthri tis Knowledge Questionnaire (KQ) and visual analog scale for pain (VAS ). Duration of morning stiffness, grip strength, and tender joint coun t were also collected at each assessment. Outcome analysis was conduct ed using analysis of variance. Results, Of 150 eligible and randomized participants, 127 completed the study according to protocol. Baseline analysis showed no differences between the EG and CG for demographics , disease status, or other characteristics. At the 6 week assessment, primary outcome analysis for those who completed the protocol identifi ed a mean change (improvement) of 13.5% in the EG and 5.8% in the CG, representing a 7.7% difference in change scores between the 2 groups [ F(1,121) = 6.03; p = 0.015]. A statistically significant difference in change scores was also identified for the KQ [F(1,120) = 6.67; p = 0. 011], but not for the VAS. Disease status measures did not change, exc ept for duration of morning stiffness, which improved by 68.8 min in t he EG and 8.3 min in the CG (F(1,121) = 4.50; p = 0.036]. Conclusion. Four hours of a community based PT intervention delivered over 6 weeks significantly improved self-efficacy, disease management knowledge an d morning stiffness in people with RA.