Rehabilitation for rheumatic diseases is changing. In a new special issue of the Journal of Clinical Medicine, Rikke Helene Moe (Diakonhjemmet Hospital) and Thea Vliet Vlieland (Leiden University) show how personalized approaches, digital solutions and interdisciplinary collaboration can help meet the needs of the future. At the same time, the research points to clear knowledge gaps – from better patient selection to more effective measures to enhance work capacity, physical activity and quality of life.
The research they discuss highlights four important areas:
🔼 The importance of personalized, biopsychosocial approaches
🔼 The use of more practical tests to monitor or screen physical fitness (e-CRF models)
🔼 Measures to support work ability and physical activity
🔼 Digital and interdisciplinary models, including remote monitoring
The studies also point to knowledge gaps – including the need for more research on effective interventions, better patient selection (right patient, right treatment at the right time) and adaptation to individual needs.
To meet the challenges of the future, the authors highlight three main tracks:
🔼 more prevention and healthy lifestyle from an early age
🔼 strengthening injury prevention (e.g. neuromuscular training in sports)
🔼 collaboration across sectors to integrate rehabilitation into holistic treatment courses
Development of tools
The authors point out that the development of modern rheumatological rehabilitation shows an increased focus on good assessment methods, development, evaluation and implementation of biopsychosocial models for personalized treatment, interdisciplinary collaboration and integration of remote follow-up – particularly e-health – to enhance patient outcomes.
They write that there are several general key trends that should be prioritized to develop and implement effective strategies for prevention, secondary prevention, and treatment within rehabilitation.
New knowledge
“The special issue contributes important new knowledge to the field,” explains Rikke Helene Moe. She explains why:
It highlights, among other things, the assessment of functional limitations, functional impairment and aerobic capacity, the effect of rehabilitation measures, a deeper understanding of psychosocial aspects of pain management and coping, and new models for rehabilitation.
The special issue also provides insight into specific functional problems faced by people with rheumatic musculoskeletal diseases.
It also points out possible alternatives to time- and equipment-intensive tests, which are important in rheumatological rehabilitation, such as testing physical fitness. Here, applications for estimated models (e-CRF models) are highlighted. This is seen as an opportunity for healthcare professionals without equipment and special expertise to test patients, and then select those who need the time- and equipment-intensive tests the most.
One of the studies showed a need for more research on effective interventions to support maintaining work capacity and physical activity. Moe emphasizes that it remains challenging to select which patients will benefit most and adapt interventions based on individual needs. This was also confirmed in a qualitative study on pain management.
Another, new interdisciplinary outpatient rehabilitation model showed the potential of innovative strategies, which, among other things, can include remote monitoring to provide professional support to healthcare personnel who are not specialists in rheumatic and musculoskeletal diseases.
Moe says that one of the studies suggested that an active coping strategy, which is often used in rehabilitation, can lead to increased use of health services. She asks us to remember that this is health economic research, not an assessment of the benefit compared to the investment that rehabilitation is to maintain or improve health and function in people who need it.
The authors emphasize that these findings are important for patients, clinicians, health services, health policymakers, and researchers in the development of future rehabilitation models.
Conclusion of the knowledge review
🔼 More attention must be paid to prevention and healthy lifestyles for those at risk of developing rheumatic diseases and musculoskeletal disorders. It is particularly important to start early – for example through health-promoting education in schools – to make the most of prevention opportunities.
🔼 Injury prevention should be given a clearer priority. Research shows that measures against knee injuries can reduce the risk of knee osteoarthritis by up to 12 percent. Simple exercises within neuromuscular training in sports are important to achieve this.
🔼 Better use of digital and updated strategies is needed to share evidence-based advice on simple treatment methods. This way, people can access knowledge and tools even before they see their GP or health service for musculoskeletal disorders.
🔼 Collaboration between different actors – such as the pharmaceutical industry and the technology sector – should be strengthened. The goal is to better integrate non-medical measures and rehabilitation into treatment courses and to find the best possible content, amount, timing and combinations with other treatments.
Read the introduction to the article: JCM | Special Issue : Physiotherapy and Rehabilitation for People with Rheumatic and Musculoskeletal Diseases
Read the full article: Rehabilitation for People with Inflammatory Arthritis: Meeting the Challenges of a Changing Healthcare Landscape
Please read what the head of the Norwegian Physiotherapy Association thinks about rehabilitation.
