Problems of Physical Therapy of Psoriatic Arthritis with Comorbidities

Abstract

Psoriatic arthropathy is a chronic inflammatory disease of the musculoskeletal system associated with psoriasis, which affects 1-2 people per 1,000 adults. It is a multifaceted disease characterized by various combinations of peripheral arthritis, dactylitis, spondylitis and enthesitis. At the same time, musculoskeletal manifestations can be combined with non-articular pathology involving the skin, nails, mucous membranes and internal organs. The purpose of the study was to evaluate the world experience of rehabilitation of motor disorders in patients with psoriatic arthropathy with comorbid conditions and to develop the most promising tasks of physical therapy. Materials and methods. To achieve this purpose, an analysis of literature sources in modern databases was conducted: Google Scholar, RSCI, Web of Science, Scopus, PubMed, Medline, Cochrane Central Register of Controlled Trials. Depth of search is 20 years (from January 2002 to November 2021). Results and discussion. Diagnosis of psoriatic arthropathy is relatively normal. However, taking into account all manifestations of psoriatic arthropathy remains a difficult task in practice. The development of key features of the disease for the possibility of forming a prognosis of rehabilitation and restoring the maximum functioning of the patient remains a particularly important and unsolved task. Despite significant advances in pharmacological treatment in recent years, the effectiveness of rehabilitation of patients with psoriasis, in particular with the clinical manifestation of psoriatic arthropathy, is always limited. Inadequate therapy or tolerance to existing psoriatic arthropathy therapy leads to limited joint mobility, reduced ability to perform daily activities, including walking, and, as a consequence, reduced quality of life. In addition, psoriatic arthropathy is often combined with comorbid pathology, which adversely affects the course of the underlying disease, complicates the choice of therapeutic agents, worsens the prognosis and reduces the life expectancy of patients. Conclusion. Given the significant prevalence, chronic recurrent nature of psoriatic arthropathy, progression of arthropathy with subsequent development of limited joint mobility, frequent combination of psoriatic arthropathy with comorbid pathology significantly reduce the effectiveness of treatment and quality of patients’ life. This requires the development and scientific substantiation of new rehabilitation programs