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BackgroundHaving an important negative impact not only on bone health, but also on general health, with serious consequences as the fragility fractures, osteoporosis had became a major public health problem, with high socio-economic cost.ObjectivesThe aim of this study was to assess the efficacy of a 6 months ambulatory exercise program on functional status and quality of life in women with postmenopausal osteoporosis.MethodsThe randomized, controlled, observational study included 81 patients with postmenopausal osteoporosis, mean age 68.7±7.3 years, randomly assigned to a control group (40 patients) and an exercise group (42 patients). All patients were diagnosed with osteoporosis based on DEXA assessment and had a stable cardiovascular status. All patients continued to take their prescribed medication for osteoporosis. They followed exercise programs based on increasing spinal mobility, muscular strength and endurance, improving balance, coordination, respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study and after 6 months based on spinal mobility, muscular strength, pain assessment on a Visual Analogue Scale (VAS) and quality of life evaluation using SF-36 Questionnaire.ResultsThe benefits of the kinetic programs were shown by a significant improvement on spinal mobility and muscular strength for spinal extensor and abdominal flexor muscles. For muscular strength, the values we obtained followed an ascendant curve for all the tested muscular groups and the results had high statistic significance. Pain, evaluated on a Visual Analogue Scale, had a mean decrease of 3.558 points and the results were also high statistic significant (p=0.000054). For SF-36 Questionnaire, the best results were obtained for vitality (37.2% amelioration), mental health (20.8% amelioration) and body pain (53.5% amelioration) domains and were also statistic significant (p<0.05). The results for the control group remained basically unchanged. The compliance of the study participants was very good: only three patients did not completed the 6 months training program.ConclusionsThe physical exercise program improves both functional status and quality of life in patients with postmenopausal osteoporosis by increasing spinal mobility and muscular strength and by reducing pain. Kinetic programs that combine aerobic exercise with exercises for increasing muscular strength and endurance, balance and coordination should be introduced in the rehabilitation programs of patients with osteoporosis without medical contraindications for moderate level exercise.Disclosure of InterestNone declared

Background Hip osteoarthritis evolution is slow, but progressive, with increasing degradation of the joint, worsening instability, with permanent pain and reduced walk perimeter. Objectives The purpose of this study was to examine the effects of a 3 weeks kinetic program on pain and the functional status of patients with hip osteoarthritis. Methods We conducted an observational, prospective, randomized study on a sample of 80 patients previously diagnosed with hip osteoarthritis. The patients were randomly assigned to a control group (40 patients) who received electrotherapy, physical therapy and massage (group 1) and a study group (40 patients) whose therapeutic program included electrotherapy, physical therapy, massage and daily physical exercise (group 2). Rehabilitation program of patients had the following general objectives: increase the function or maintenance of the existing function and prevent failures and disability by reducing pain and inflammation, maintaining or increasing muscular strength and joint mobility. Evaluation of patients was done on day1 and after 3 weeks of rehabilitation treatment. The clinical and functional parameters assessed were: pain on a visual analogue scale (100 mmVAS), physical impairments (muscular strength, static disorders and mobility of hip joint), and disabilities (Tinetti Gait Scale, ADL 24, D’Aubigné Scale and movement capacity). Results After the 3 weeks rehabilitation program, the scores for functional parameters improved as follows: pain- 43.5% (group 2) and 32.9% (group 1) and the results were high statistic significant (p=0.000054); physical impairments : muscular strength- 9.7% (group 2), without improving by group 1, static disorders- 24.6% (group 2) and 13.6% (group 1), mobility of hip joint: 34.8% (group2) and 23.2% (group 1); disabilities: Tinetti Gait Scale- 36.3% (group 2) and 22.1% (group 1), ADL- 53.6% (group 2) and 40.2% (group 1), D’Aubigné Scale- 34.7% (group 2) and 25.9% (group 1), movement capacity- 45.7% (group2) and 32.7% (group 1). The results were also statistic significant (p<0.05). The compliance of the study participants was very good: only three patients did not complete the 3 weeks rehabilitation program. Conclusions Improvement of pain, physical impairments and disabilities for the study group certifies the efficacy of the rehabilitation program including physical exercise for the patients suffering from hip osteoarthritis and motivates the continuation of the study on a longer period of time and on a larger number of patients. Disclosure of Interest None Declared

BackgroundKnee osteoarthritis is a long- term disease and its medical management is not always effective in reducing pain or improving mobility. The studies concerning the quality of life in patients with knee osteoarthritis proved the impact of functional impairment on their daily living activities and on their social and professional life.ObjectivesThe main purpose of this observational study was to evaluate the efficacy of complex rehabilitation treatment and its influence on the functional status and on the quality of life in patients with knee osteoarthritis and to identify possible correlations between various clinical and functional parameters.MethodsThe study included 138 patients with knee osteoarthritis (diagnosed according to the American College of Rheumatology criteria), mean age 64.52±11.63 years. All patients performed a complex rehabilitation program for 12 days and were evaluated clinical and functional at baseline, at 2 weeks and at 8 weeks. We used VAS scale for pain measure, WOMAC index for functional status and the Short Form 36 Helth Survey (SF-36) for assessing quality of life. The physical performance measures included the Six- Minute Walk Test (SMW) and the Timed “Up & Go” Test (TUG).ResultsThe efficacy of physical-kinetic treatment is reflected by statistically significant improvements (p<0.05) of mean scores for functional status and for quality of life questionnaires, for pain evaluated on a visual analogue scale (VAS). WOMAC influence on SF-36 improvement is well above 50%; there is a correlation between indicators estimated as moderately high (0.8). Multivariate analysis showed that physical performance measures (SMW and TUG) correlated statistically with pain measure (VAS score) and WOMAC index.ConclusionsImprovement of the clinical and functional parameters has a significant impact on increasing the quality of life in patients with knee osteoarthritis.Disclosure of InterestNone declared

BackgroundPlanning a pregnancy in rheumatoid arthritis (RA) meets several issues, mostly concerning potential drug toxicity and disease flares.ObjectivesThe purpose of this study is to evaluate pregnancy planning, RA activity during pregnancy and postpartum, pregnancy and fetal outcomes in a Romanian cohort of female patients diagnosed with RA.MethodsWe designed an observational ambispective study which included 36 RA Caucasian females with obstetric history after the onset of RA (14 - prospective, 22 - retrospective). The cases were obtained from several Clinics of Rheumatology from Romania.ResultsThe mean age at inclusion is 39.88 years, age at RA diagnosis 24.97 years and mean age at conception 31.03 years.We recorded a total number of 65 pregnancies: 29 deliveries at term, 3 premature births, 12 elective abortions, 20 spontaneous abortions (attributed to trombophilia, methotrexate [MTX], Leflunomide and Toxoplasmosis gondii) and 1 ongoing.24/36 (66.6%) had only one pregnancy after the onset of RA and 7/36 (19.4%) were multipares before the diagnosis. 47.6% had at least one unplanned pregnancy, while being on treatment with DMARDs.Concerning the exposure to synthetical DMARDs during the pregnacy:5 patients received Leflunomide and 2 received MTX during the first trimester, the pregnancy outcomes being: 2 spontaneous abortion, 2 elective abortions, 2 normal birth, 1- premature twin pregnancy.In case of biologic DMARDs: 2 were exposed to Etanercept until weeks 2 and 3 (normal birth), and 1 to Infliximab – week 4 (elective abortion). In patients receiving Rituximab the washout period varied from 4 weeks in 2 pregnancies (1- spontaneous abortion and 1 normal birth) to 48 weeks (2 normal births and 1 premature).We registred 3 patients on biological therapy, which stopped the treatment with 2 years before the planned preganncy (Etanercept), respectivelly 6 months (Etanercept and Adalimumab)66.6 of our patients were in Remission or Low Disease Activity (DAS28CRP) at preconception.Maintaing or improvement of the disease activity during the pregnancy were the principal trend in our population, excepting 2 situations.The average pregnancy length was 35.2 weeks, with 3 preterm deliveries and the mean birthweight was 2624 grams. No fetal abnormality was identifiedFive patients never had a new flare postpartum, while in the others the mean time to flare postpartum was 9 weeksConclusionsPatients with RA can have successful pregnancies. The pregnancy is planned in about half of cases. Pregnancy decreases disease activity, but many deliveries are followed by RA flares. No fetal abnormalities were diagnosed.ReferencesPregnancy in autoimmune rheumatic diseases: The importance of counselling for old and new challengesL.Andreoli, C Bazzani M.Tarabo-relli, R. Reggia, A. Lojacono, A. Brucato, P.L Meroni, A. Tincani, Autoimmunity Reviews 10 (2010) 51–54Disclosure of InterestNone declared