The Present State and Future Direction of Rehabilitation Medicine in the Treatment of Rheumatoid Arthritis

Protraction of RA induces joint function disorders resulting in a deterioration in the activities of daily living (ADL), which can cause a change in the patient's household role and limit their social participation. As there is not at present a curative treatment for RA, once functional disorders develop, they cannot be recovered easily or completely. However, it was recently reported that disorders progress rapidly within a few years from RA disease onset in terms of the changes wrought by joint damage and the resulting functional disorder inflicted on the patient. Therefore, it is proposed that adequate administration of methotrexate should be started initially and that RA treatment should be based on the recommendations under the regime of Treat to Target (T2T). Rehabilitation for RA patients includes various kinds of exercises and approaches such as physical therapy in the early stage and nursing home service with caregiver insurance in the terminal RA phase. In terms of the principles of T 2 T, the aim of the RA treatment is to improve the patients' long-term QOL as much as possible during their lifetime through the restoration of body functions and their participation in social activities. The ultimate aim of rehabilitation is the same as that of T 2 T because it is to let people with disabilities live normal lives by diminishing the difficulties RA patients face in daily life and improving their QOL. It is therefore very important to keep in mind that RA is a complex condition that includes people with various afflictions and difficulties in meeting their daily living tasks and not just one disease.