Exercise therapy Rheumatoid disesases Rheumatoid arthritis Individual approach to accomodate to current condition Acute stage: cryotherapy liquid nitrogen- localy, whole body In remisions: parafin wraps whirpool, aquatic therapy ultrasound, laser Physical rest Positioning in a sling Thermoplastic splints Functional splinting Passive movements Traction, relieving tractions Cervical soft tissue relieving tractions Relaxation Joint mobilisation Isometric contractions Rheumatoid artritis Gradualy more active movements -to strengthen atrophic muscles - Active exercise: muscle tone, ROM, muscle strength Gait training (crutches) Aerobic fitness training Occupational therapy Balneology Rheumatoid artritis Ancylosing spondylitis Daily exercice program- daily routine at least 30 minutes/day Early education about the disease Cooperation of the patient Exercise therapy is fundamental Active movements every day The aim- to slow down spinal ancylosing process to prevent kyphotic deformity Ancylosing spondylitis Spinal and thoracic mobility Muscle balance and ROM Postural corrections Maximum breathing capacity Patient´s overal fitness Ancylosing spondylitis Stage of high level activity: Positioning Passive exercise Breathing exercise Soft tissue techniques Active exercise Ancylosing spondylitis Stage of moderate or low level activity: Postural reeducation Gentle mobilisation of sacroiliacal joints Spine and rib mobilisations Release of shortened muscles Chest breathing Deep spine exercise General relaxation Ancylosing spondylitis Stage of moderate or low level activity: Maintenance of optimal mobility Stretching, exercise into backward bending Somatognostic training Swing movements Using of balls, wands, resistive bands,wall bars Group exercise Physical therapy: Magnetic field application, ultrasound, electrotherapy Balneotherapy Exercise therapy Overloading conditions Principles of rehabilitation Acute stage – cryotherapy Chronic stage- to address oedema muscle imbalance limited ROM physical therapy - hydrotherapy, underwater masage ultrasound - antiinflammatory effect pulsed magnetic field – effect on osteoporosis Overloading Acute stage- rest, orthesis local and systemic NSAID local corticosteroids Chronic stage- treatment of oedema and inflammation physical therapy soft tissue techniques joint mobilisation electrotherapy- DD, TENS, laser… Chronic stage of overloading Muscle relaxation To correct muscle contractions in neutral joint alignment PIR, antigravity relaxation, Vojta ´s method locomotion Closed kinetic chain exercise Ultrasound and combined electrotherapy To improve poor posture To stop pathological movement stereotypes Spinal mobilisation Muscle activation Lumbopelvic stabilisation- to get correct pattern To modify pathological movement pattern Training in neutral joint position Chronic stage Releas local spasms- trigger points -deep muscle massage, PIR - ultrasound, shock wave therapy, contrast baths Excentric exercise To affects surrounding muscles ( e.g. elbow- scapular muscles) Ergonomics to be modified To modify training methods To strengthen the muscles -