Rehabilitation in warm climate for young adults with inflammatory arthritis - A 12 months randomized controlled trial
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Background: Rehabilitation in warm climate has long been an established nonpharmacological treatment for patients with inflammatory arthritis (IA) in Norway. It has however not been tailored to the needs of young adults, who often have different challenges than older adults with IA. Aims: The aim was to investigate if a rehabilitation program in warm climate especially developed for young adults with IA showed indications of a long term effect on general health status compared to usual care. Method: We did an open randomized controlled trial. Patients aged 20-35 years, with inflammatory arthritis (IA) were randomized to the intervention (n=20) or usual care (n=20). The intervention was a 17 day long rehabilitation program in warm climate, and the main component was intensive exercise, individual physiotherapy and patient education. The primary outcome measures was physical function assessed by the “30 second Sit to Stand test” and self-management/coping measured by the “Effective Musculoskeletal Consumer Scale” (EC17). Results: Forty patients (mean age 27.5, 65 % female) with IA were randomized. 19 out of 20 patients completed the intervention. At twelve months follow up there were 3 patients lost to follow up from the intervention group, and 2 in the control group. The intervention group had a significant improvement in the physical function test at 3 months; mean difference (95% CI): 7.6 (4.3 to 10.9), 6 months 4.7 (0.7 to 8.8) and 12 months 6.8 (2.3 to 11.3), compared to the control group. There were no difference in self-management/coping measured with EC17 between the two groups at 3, 6 or 12 months. Conclusion: This study indicates that a rehabilitation program in warm climate especially developed for young adults with IA improves patient’s physical function, but not selfmanagement/coping up to one year after the intervention. Further studies are needed to confirm these findings. Relevance: This is the first study to investigate a rehabilitation program in warm climate especially for young adults with IA. Bringing new knowledge in this field is important as this patient group often encounter complex challenges, and have a need for multidisciplinary rehabilitation. Yet, there is a lack of rehabilitation programs targeted toward young adults with IA, and for young adults with chronic disease overall.