title: Improvements following short term home based physical therapy are maintained at one year in people with moderate to severe rheumatoid arthritis.
abstract: OBJECTIVE
  We previously demonstrated the efficacy of a 6 week home based physical therapy (PT) intervention for people with moderate to severe rheumatoid arthritis (RA). This followup study determined if short term improvements were maintained to one year.
  
  
  METHODS
  Participants in the short term study were randomly assigned to receive a PT intervention (education, exercise, and pain relief modalities) delivered by physiotherapists with advanced rheumatology training (Weeks 0 to 6) or to a wait list control group. The control group received the intervention between Weeks 6 to 12. Outcome measures included the Stanford Arthritis Self-Efficacy Scale (SES), the Arthritis Community Research and Evaluation Unit Rheumatoid Arthritis Knowledge Questionnaire (KQ), and a visual analog scale for pain. Disease activity measures (tender joints, grip strength, and morning stiffness) were also included. MANOVA was used to compare within-subject scores at baseline and at 12 and 52 weeks. Paired t tests were used to determine if 12 week changes were maintained at 52 weeks.
  
  
  RESULTS
  Of the 127 protocol completers, 117 (92.1%) were available for the one year followup. For those measures that showed significant improvement in the randomized controlled trial (SES, KQ, morning stiffness), improvements at 12 weeks were maintained at 52 weeks (p > 0.010).
  
  
  CONCLUSIONS
  Subjects who participated in a short term home based PT intervention delivered by specially trained therapists reported improved outcomes following treatment, and these improvements were maintained at one year followup. Future studies need to explore the relative contributions of education, exercise, home based care, therapist training, and reinforcement strategies in improving longterm outcomes in RA.
authors.affiliation: Arthritis Community Research and Evaluation Unit, The Arthritis and Immune Disorder Research Centre, Health Research Division, University Health Network, Toronto, Ontario, Canada. slineker@on.arthritis.ca
authors.forename: S C
authors.initials: SC
authors.lastname: Lineker
authors.forename: M J
authors.initials: MJ
authors.lastname: Bell
authors.forename: A L
authors.initials: AL
authors.lastname: Wilkins
authors.forename: E M
authors.initials: EM
authors.lastname: Badley
mesh_terms: D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006304:Health Status; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D018583:Pliability; D011380:Programmed Instructions as Topic; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome