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L'Artrite Reumatoide

L’artrite reumatoide (AR)è una malattia infiammatoria cronica di natura autoimmune. 
Questa patologia viene anche definita Poliartrite Cronica Primaria: l’infiammazione infatti colpisce più articolazioni (poli), ha un andamento progressivo (cronica) e non presenta una causa nota (primaria).
Il primo bersaglio dell’artrite reumatoide è la membrana sinoviale (la membrana interna che riveste la capsula articolare) con conseguente degenerazione della superficie articolare, deformazione e compromissione irreversibile dell’articolazione stessa. I sintomi più frequenti sono tipici del processo infiammatorio, quali arrossamento, calore, gonfiore articolare e prolungata rigidità mattutina. Questi di certo non sono gli unici. L’AR infatti è una malattia “sistemica” e può provocare per esempio sintomi oculari, respiratori, cardiaci e in particolare la comparsa dei cosiddetti “noduli reumatoidi”.
Le articolazioni maggiormente colpite sono quelle delle dita (metacarpo-falangee e interfalangee prossimali), polsi, gomiti, colonna cervicale, ginocchia e caviglie.
L’AR ha una prevalenza compresa tra lo 0,3% e l’1,5% della popolazione mondiale e in Italia la percentuale si aggira attorno allo 0,5%; colpisce tutte le età con un picco tra i 35 e i 50 anni e con un rapporto femmine:maschi di 3:1.
Per quanto riguarda la terapia, oltre al trattamento farmacologico, il ruolo della fisioterapia è di estrema importanza per ridurre dolore e tumefazioni articolari, ripristinare il range articolare, migliorare il tono muscolare e la resistenza fisica. Il paziente stesso può adottare dei piccoli accorgimenti per andare a stressare il meno possibile le articolazioni, come per esempio:

  • portare i pesi il più possibile vicino al corpo e con tutte e due le mani o le braccia per evitare di sovraccaricare gli arti superiori;
  • utilizzare le articolazioni più grandi e forti per facilitarsi (es. chiudere un’anta con l’anca invece che con la mano);
  • evitare sforzi inutili;
  • riposare in modo adeguato.

Esistono in particolare consigli utili per quanto riguarda le attività quotidiane:

  • ALIMENTAZIONE: evitare posate con manici sottili, preferire quindi quelle con manico grosso e presa a piena mano;
  • ABBIGLIAMENTO: vestire per prima la parte inferiore del corpo, meglio se stando seduti; preferire abiti facili da indossare e comodi, a chiusura anteriore e con bottoni grandi (per evitare troppo stress alle piccole articolazioni delle mani);
  • IGIENEPERSONALE: effettuare le attività quotidiane (fare la doccia, lavarsi i denti, spazzolarsi, ecc.) stando seduti se possibile; utilizzare strumenti dal manico largo per assicurare un’impugnatura stabile;
  • CUCINA: porre gli strumenti per cucinare in posti facili da raggiungere (per esempio utensili più pesanti all’altezza della vita per non affaticarsi troppo); organizzare i pasti in modo regolare, raggruppando gli ingredienti e gli strumenti vicini per non doverli cercare in continuazione; aiutarsi con gli apparecchi elettrici;
  • PULIZIE: evitare di piegarsi per pulire, utilizzare quindi utensili di adeguata lunghezza o sedersi se possibile; preferire movimenti lenti con entrambe le mani;  preferire l’utilizzo di elettrodomestici; compiere movimenti dall’alto verso il basso (per sfruttare la gravità).

 
Qui troverete qualche esempio di esercizi da poter effettuare indipendentemente:

ESERCIZIO 1:
auto-stretching: in posizione seduta unire le mani dietro la schiena, mantenendo i gomiti estesi e la schiena dritta; portare indietro le spalle (immaginate come se le vostre mani fossero tirate indietro da una corda).
Mantenere la posizione per 30 secondi.


ESERCIZIO 2:
auto-stretching: in piedi, piegare il ginocchio e afferrare la caviglia con la mano, facendo attenzione a non piegare la schiena (potete appoggiare l’altra mano ad un piano per essere più stabili).
Mantenere la posizione per 30 secondi per ciascuna gamba.


ESERCIZIO 3:
distesi a pancia in su con la schiena ben appoggiata a terra, piegare la gamba e con il braccio opposto avvicinarla al petto; distendere l’altro braccio verso l’alto contemporaneamente.
Mantenere la posizione per 15 secondi per ciascuna gamba; ripetere due volte.








ESERCIZIO 4:
distesi a pancia in giù con i gomiti appoggiati, sollevare il busto cercando di non staccare la pancia da terra.
Mantenere la posizione per 15 secondi; ripetere due volte.










Quelli che vi abbiamo proposto sono semplici esempi di esercizi che si possono svolgere benissimo a casa, ma in generale si raccomanda di adottare uno stile di vita sano e di praticare regolare esercizio fisico (camminare, nuotare, fare stretching, ecc.).



Bibliografia:
“Esercizio terapeutico: fondamenti e tecniche” C. Kisner, L. A. Colby
www.anmar-italia.itAssociazione Nazionale Malati Reumatici”
“Atlante di anatomia ortopedica di Netter” J. C. Thompson
Per le immagini:

1061 commenti a L'Artrite Reumatoide:

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