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||Siegel, P., Tencza, M., Apodaca, B., & Poole, J. L. (2017). Effectiveness of occupational therapy interventions for adults with rheumatoid arthritis: A systematic review. American Journal of Occupational Therapy, 71(1), 1-11.
||Arthritis, assistive technology, chronic fatigue syndrome, daily living, depression, exercise, functional limitations, intervention, literature reviews, musculoskeletal disorders, occupational therapy, outcomes, pain, patient education, psychotherapy
||This systematic review examined the effectiveness of occupational therapy interventions that address function, pain, fatigue, and depression in adults with rheumatoid arthritis. Fifty-one Level I studies (19 physical activity, 32 psychoeducational) published between January 2000 and July 2014 were identified from five databases. Interventions that focused solely on the upper or lower extremities were not included. The physical activity interventions discussed in the articles were divided into six subthemes: (1) home exercise and coaching, (2) dynamic exercise, (3) aquatic exercise, (4) aerobic exercise, (5) resistive exercise, and (6) Tai Chi and yoga. The psychoeducational interventions assessed in the articles were divided into seven subthemes: (1) patient education and self-management, (2) cognitive-behavioral therapy, (3) multidisciplinary approaches, (4) joint protection, (5) assistive devices, (6) emotional disclosure, and (7) comprehensive occupational therapy. Findings related to key outcomes (activities of daily living, ability, pain, fatigue, depression, self-efficacy, disease symptoms) are presented. Strong evidence supports the use of aerobic exercise, resistive exercise, and aquatic therapy. Mixed to limited evidence supports dynamic exercise, Tai Chi, and yoga. Among the psychoeducation interventions, strong evidence supports the use of patient education, self-management, cognitive-behavioral approaches, multidisciplinary approaches, and joint protection, and limited or mixed evidence supports the use of assistive technology and emotional disclosure. The evidence supports interventions within the scope of occupational therapy practice for rheumatoid arthritis, but few interventions were occupation based.
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