Clinical Disease Activity and Power Doppler Changes Observed During a Multimodal Rehabilitation Program in Rheumatoid Arthritis: A Retrospective Longitudinal Observational Study
6 affiliations
- 1Faculty of Medicine, Departament 9, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- 2Research Centre in the Medical-Pharmaceutical Field, Medicine and Pharmacy Faculty, “Dunărea de Jos” University of Galati, 800010 Galați, Romania
- 3Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 900470 Constanta, Romania
- 4Faculty of Medicine, Department 1, University of Medicine and Pharmacy of Craiova, 200345 Craiova, Romania
- 5Faculty of Medicine, Department 2, University of Medicine and Pharmacy of Craiova, 200249 Craiova, Romania
- 6Faculty of Medicine, Department of Neurology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Abstract
Background/Objectives: Rehabilitation in active rheumatoid arthritis (RA) remains challenging, particularly regarding the dosing of physical agent modalities during inflammatory activity. We evaluated changes in clinical disease activity, inflammatory markers, and Power Doppler (PD) activity in patients with RA undergoing individualized multimodal rehabilitation. Methods: In this retrospective longitudinal study, 29 patients with RA were assessed at baseline and after 8 weeks. The program comprised 10 supervised sessions of individualized electrotherapy and therapeutic exercise over 2 weeks, followed by 6 weeks of home-based exercise. Background disease-modifying antirheumatic therapy was unchanged; 16 patients received ESR-guided methylprednisolone. Outcomes included DAS28-ESR and its components, C-reactive protein (CRP), and patient-level PD grade across a standardized joint set. Results: DAS28-ESR decreased from 6.05 ± 0.87 to 4.03 ± 0.82, with significant reductions in all its components and in CRP (all p < 0.001). Patient-level PD grade showed a significant shift toward lower grades, from a median of 2 [IQR 2–3] at baseline to 2 [IQR 1–2] at 8 weeks (p < 0.001); 18 patients (62.1%) improved, and none worsened. Changes in DAS28-ESR and PD grade were not significantly correlated (ρ = 0.181, p = 0.348). In the 13 patients who did not receive additional glucocorticoids, DAS28-ESR decreased from 5.22 to 3.41 (p < 0.001), while median PD grade changed from 2 [IQR 2–3] to 2 [IQR 2–2] (p = 0.016). Conclusions: Improvements across clinical, laboratory, and ultrasound domains were observed during individualized rehabilitation delivered alongside pharmacological treatment, while the magnitude of clinical and ultrasound changes was not significantly correlated. Because of the absence of a control group, concomitant glucocorticoid and NSAID therapy, and the possibility of regression to the mean, the contribution of rehabilitation cannot be isolated from pharmacological treatment, natural disease course, and other sources of change. Controlled studies of dose-adapted rehabilitation in active RA, prescribed by the rehabilitation physician in collaboration with the rheumatologist, are warranted.
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BibTeX
@article{daia2026clinical,
title = {{Clinical Disease Activity and Power Doppler Changes Observed During a Multimodal Rehabilitation Program in Rheumatoid Arthritis: A Retrospective Longitudinal Observational Study}},
author = {Cristina Octaviana Daia and Madalina Codruta Verenca and Mirela Manea and Elena Valentina Ionescu and Caimac Visarion Danut and Alexandra Maria Poenaru Gilceava and Elena Anca Târtea and Ana Maria Bumbea},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208117},
url = {https://www.mdpi.com/2077-0383/15/20/8117},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinical Disease Activity and Power Doppler Changes Observed During a Multimodal Rehabilitation Program in Rheumatoid Arthritis: A Retrospective Longitudinal Observational Study
AU - Cristina Octaviana Daia
AU - Madalina Codruta Verenca
AU - Mirela Manea
AU - Elena Valentina Ionescu
AU - Caimac Visarion Danut
AU - Alexandra Maria Poenaru Gilceava
AU - Elena Anca Târtea
AU - Ana Maria Bumbea
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208117
UR - https://www.mdpi.com/2077-0383/15/20/8117
AB - Background/Objectives: Rehabilitation in active rheumatoid arthritis (RA) remains challenging, particularly regarding the dosing of physical agent modalities during inflammatory activity. We evaluated changes in clinical disease activity, inflammatory markers, and Power Doppler (PD) activity in patients with RA undergoing individualized multimodal rehabilitation. Methods: In this retrospective longitudinal study, 29 patients with RA were assessed at baseline and after 8 weeks. The program comprised 10 supervised sessions of individualized electrotherapy and therapeutic exercise over 2 weeks, followed by 6 weeks of home-based exercise. Background disease-modifying antirheumatic therapy was unchanged; 16 patients received ESR-guided methylprednisolone. Outcomes included DAS28-ESR and its components, C-reactive protein (CRP), and patient-level PD grade across a standardized joint set. Results: DAS28-ESR decreased from 6.05 ± 0.87 to 4.03 ± 0.82, with significant reductions in all its components and in CRP (all p < 0.001). Patient-level PD grade showed a significant shift toward lower grades, from a median of 2 [IQR 2–3] at baseline to 2 [IQR 1–2] at 8 weeks (p < 0.001); 18 patients (62.1%) improved, and none worsened. Changes in DAS28-ESR and PD grade were not significantly correlated (ρ = 0.181, p = 0.348). In the 13 patients who did not receive additional glucocorticoids, DAS28-ESR decreased from 5.22 to 3.41 (p < 0.001), while median PD grade changed from 2 [IQR 2–3] to 2 [IQR 2–2] (p = 0.016). Conclusions: Improvements across clinical, laboratory, and ultrasound domains were observed during individualized rehabilitation delivered alongside pharmacological treatment, while the magnitude of clinical and ultrasound changes was not significantly correlated. Because of the absence of a control group, concomitant glucocorticoid and NSAID therapy, and the possibility of regression to the mean, the contribution of rehabilitation cannot be isolated from pharmacological treatment, natural disease course, and other sources of change. Controlled studies of dose-adapted rehabilitation in active RA, prescribed by the rehabilitation physician in collaboration with the rheumatologist, are warranted.
SN - 2077-0383
ER -