The role of physiotherapy in optimizing work ability in people with inflammatory arthritis

Abstract

Work disability is common in people with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) and has a significant impact on their well-being, as well as an economic impact. Supporting work participation is therefore essential and requires collaboration between patients, healthcare professionals (HCPs), and employers. This thesis examined the extent and nature of work-related support provided by HCPs and employers to (self-)employed individuals with RA or axSpA, showing that only half of work-related discussions led to work-related support. Physiotherapists (PTs) play an important role in the care for people with RA or axSpA. A systematic review of clinical trials on PT-led exercise programs in this patient group concluded that the reporting of work outcomes is scarce and therefore the impact of exercise on work outcomes is inconclusive. A randomized controlled trial evaluated the (cost-)effectiveness of a specific, multimodal, PT-led vocational intervention in people with RA or axSpA and reduced work ability showed no clinical benefit, but lower costs from the societal perspective as compared to usual care. These findings, and suggestions from the process evaluation warrant the need for further optimization and evaluation of the role of the PT in the management of work disability in people with RA or axSpA.