The efficacy of rehabilitation in warm and cold climates for patients with rheumatic and neurological diseases : Three randomised controlled studies
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AbstractThe Section for Climate Therapy offers a 4-week in-patient rehabilitation programme in a warm and sunny climate for some selected chronic diseases. The main purpose of this PhD thesis was to investigate the effect of a multidisciplinary rehabilitation programme, and to compare the effect of this intervention given in a warm versus a cold climatic setting. One randomised controlled trial included patients with rheumatoid arthritis (n=124) and ankylosing spondylitis (n=107), they were randomised to rehabilitation either in a Norwegian or in a Mediterranean rehabilitation centre, and followed up after 3 and 6 months. Patients with postpolio syndrome (n=88) and heredital neuromuscular diseases (n=60) were included in two other studies with a similar design. Immediate improvements were demonstrated in different aspects of health in both climatic settings for all included diagnoses. In general, most improvements were larger and sustained longer when rehabilitation was performed in a warm climatic setting. When the attained reductions in pain and fatigue were sustained after therapy in a warm climatic setting only, improvements in the physical capacity were sustained more independently of the climatic setting. Some more specific effects of the treatment in a warm climate, were a larger reduction in disease activity parameters in rheumatoid arthritis, a sustainable increase in spinal mobility in 91% of the ankylosing spondylitis patients, and reduced depression in the postpolio patients. In conclusion, our studies show improvements of an in-patient rehabilitation programme at different levels of health for all included diagnosis, and support an additional effect when this intervention is performed in a warm climatic setting. This PhD thesis is written within the rehabilitation and rheumatology field, and the studies have been conducted at the Section for Climate Therapy at Oslo University Hospital Rikshospitalet in cooperation with Sunnaas Rehabilitation Hospital.
List of papers
|Paper I. Staalesen Strumse, Y.A.; Nordvåg, B.Y.; Stanghelle, J.K.; Røisland, M.; Winther, A.; Pajunen, P.A.; Garen, T. and Flatø, B. The efficacy of rehabilitation for patients with rheumatoid arthritis: comparison between a 4- week rehabilitation programme in a warm and a cold climate. Scand J Rheumatol 2009;38(1):28-37. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1080/03009740802304549|
|Paper II. Staalesen Strumse, Y.A.; Nordvåg, B.Y.; Stanghelle, J.K.; Røisland, M.; Winther, A.; Pajunen, P.A.; Garen, T. and Flatø, B. The efficacy of rehabilitation for patients with ankylosing spondylitis: comparison between a 4-week rehabilitation programme in a warm and a cold climate. Manuscript, published in: J Rehabil Med 2011;43(6):534-542. The published version of this paper is available at: https://doi.org/10.2340/16501977-0804|
|Paper III. Strumse, Y.A.S.; Stanghelle, J.K.; Utne, L., Ahlvin, P.; Svendsby, E.K. Treatment of patients with postpolio syndrome in a warm climate. Disabil Rehabil 2003 Jan 21;25(2):77-84. PMID:12554382. The paper is removed from the thesis in DUO due to publisher restrictions.|
|Paper IV. Nordby, P.A.; Staalesen Strumse, Y.A.; Froslie, K.F.; Stanghelle, J.K. Patients with neuromuscular diseases benefit from treatment in a warm climate. J Rehabil Med 2007 Sep;39(7):554-9. The published version of this paper is available at: https://doi.org/10.2340/16501977-0088|