Effectiveness of Cervical and Upper Shoulder Stabilization Exercises in Subjects With Rheumatoid Arthritis Patients Associated with Neck Pain
Keywords:Rheumatoid arthritis, cervical spine, shoulder joint, mobility, range of motion, pain, stabilization exercises, visual analogue scale, physiotherapy, electrotherapy.
Background: Rheumatoid arthritis is an immunological mediated, chronic inflammatory multisystem disease
which involves inflammation of the peripheral joint. Ra affects about 24.5 million people as of 2015 and the
incidence rate is more dominated amongst female. Historically the involvement of the cervical spine in later
stages of rheumatoid arthritis isn’t uncommon. Specifically, C1 and C2 are involved as they are the only
vertebrae without intervertebral disc and synovial lining and hence they are very susceptible to inflammation
due to autoimmune reaction. The alteration in the range of motion is quite significant at the cervical spine.
The biomechanics of the cervical spine and shoulder joint are interlinked with each other. The protocol of
specific cervical and upper shoulder stabilization exercises with electrical modalities like hot-moist pack
and transcutaneous electrical nerve stimulation and short wave diathermy therapy was conducted to find
out the effectiveness of scheduled, designed physiotherapy protocol of specific stabilization exercises along
with electrotherapy for cervical spine and upper shoulder stabilization exercises to see the improvement in
cervical and shoulder range of motion and pain in patients with rheumatoid arthritis
Methodology: An observational study was conducted in 25 patients at Karad with a study duration of 6
months. The inclusion criteria were the patient with rheumatoid arthritis any age and gender willingly to
participate. The outcome measures were universal goniometer for assessing cervical and shoulder range of
motion, the visual analogue scale for pain assessment.
Conclusion: The study concluded that there was a significant reduction in the range of motion in both the
cervical spine and shoulder joint. The visual analogue scale suggests there was significant pain present in
the shoulder joint and cervical spine. Post-treatment assessment suggests the improvement in the range of
motion and pain that leads to improvement in the quality of life.
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