Physical Therapists Play a Key Role in the Comprehensive Management of Rheumatoid Arthritis

Abstract

The medical management of rheumatoid arthritis (RA) has improved remarkably over the last 50 years. Today, diseasemodifying antirheumatic drugs are staples of RA management and alone, or in combination with a plethora of biologic therapies, have reduced overall RA disease activity and related joint destruction. Under the treat-to-target approach, treatment is escalated until a target of remission or low disease activity is reached and promptly escalated when the target is no longer met (1,2). These advances have greatly reduced disease activity, yet functional limitation, such as difficulty with housework, getting up from a chair, or walking, still impairs the quality of life of adults with RA, including those whose disease is in remission. Physical therapists are experts in improving and preserving physical function and optimizing quality of life for people with functional limitations, including those with RA. In this issue of Arthritis Care & Research, the 2022 American College of Rheumatology (ACR) Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis by England et al (3) presents the first systematic effort by the ACR to evaluate the contribution of physical therapy interventions to the comprehensive care of adults with RA. As physical therapists and researchers who are experts in rheumatology and who have played various roles on the guideline team, we see this guideline as a critical step toward meaningful progress in integrating physical therapy into routine care for adults with RA. To facilitate the use of this guideline by physical therapists in patient care, it is important to consider the context in which it will be used. In this editorial, we discuss the guideline's recommendations as they apply to physical therapy, challenges to implementation, and practical steps moving forward in advancing the integrative care for adults with RA.