Rheumatoid

Arthritis

Rheumatoid Arthritis (RA) is an

autoimmune disease where the
body’s immune system attacks
its own tissue, causing pain and
inflammation. RA is chronic and
progressive and can cause
deformities and immobility in
Signs and Symptoms:
joints all over the body,
(Mullen, 2017)
especially distal joints like the
Inflammation of the synovial joints
affects anywhere from one joint to hand, fingers, and ankles
multiple joints. RA can also be (Mullen, 2017).
symmetrical across both sides of the

body, or asymmetrical.

In severe cases, it can affect internal

organs like the heart, lungs, and eyes.
There can be symptom episodes, called
flares, that have no obvious cause, but
can occur when treatments are tapered
or stopped.
In RA, contractures can develop in the .04%
fingers such as a Swan Neck Deformity
and a Boutonnière deformity, and ROM is Incidence:0.04% of U.S. Adults are
severely impacted in all affected joints. diagnosed every year [Gabriel &
Treatments: Crowson, 2018]
Physical Therapy for gait
training and pain management
techniques. 1.3
Occupational therapy for
Prevalence: 1.3 million U.S. Adults
functional training in ADLs and
(0.6-1% of the US population) (Xu
modifications in the & Wu, 2021)
environment.

Cognitive Behavioral Therapy

2x
(CBT) for psychological health
and emotional issues the Male to Female ratio: Affects
disease may cause. 2x more women than men
[Gabriel & Crowson, 2018]
 Occupations:
Doing: Rheumatoid Arthritis will impact occupations including ADLs and IADLs such
as bathing, functional mobility, and personal hygiene. Due to the pain this disease
causes, it could also impact rest and sleep as well as work (AOTA, 2020).
Being: Depending on the severity of the RA, the pain and stiffness that accompanies
this disease may impact an individual's role in their life. These could include family or
work-related roles (AOTA, 2020).
Becoming: Occupational Therapists can implement interventions to help adults
overcome the pain, decreased functionality, and secondary emotional issues that
may accompany this disorder. OTs can plan interventions that target pain
management and functional mobility with the goal of comfortability and
independence when participating in occupations (AOTA, 2020).
Belonging: The goal of OT intervention is for the client to feel independent in their
daily tasks. Individuals with this disorder may feel like a burden because of the help
they require from others. OTs can provide adaptive equipment and coping strategies
to help individuals feel like they belong in their desired roles (Meda Vendrusculo-
Domains:
Fangel et al., 2019).
(AOTA, 2020)
Client Factors:
Body Functions (Neuromusculoskeletal and movement-
related functions): would want to assess any pain client
is experiencing and joint mobility given the diagnosis.
Performance Patterns:
Person (routines): Would be beneficial to assess daily
routines to see how they are impacted by the condition
Context (Environmental)
Products and technology: Can assess what products or
technology the client uses on a daily basis and what
difficulties they may be having with those tools Role of OT
Employment: is the client employed? How does this (Morgan & Long, 2012)

condition impact their ability to work? Help maintain mobility of joints, protect joints,
Context (Personal)
increase muscle strength, pain management and
Health conditions and fitness: Is the client experiencing
maintaining fine motor skills
any other health effects or suffering from other health
Training on completing ADL’s such as dressing,
conditions?
bathing, or cooking
Psychological Assets: what kind of coping skills does this
individual have? How might they handle any physical or May help with the use of orthotics or splints

psychological demands? Want to work to maximize independence in

patients with RA

Interprofessional
Collaboration
Rheumatologist: To diagnose and help treat RA

with prescribed medications.

Orthopedic Surgeon: To perform joint
replacements in people with RA when the disease
has progressed.
Psychologist: To provide CBT and other therapy in
people with RA to help them cope with chronic
pain.
Physical Therapist: To help with gait training and
overall mobility in people with RA.