Researchers investigate innovative rehabilitation techniques for arthritis patients

Glasgow Caledonian University (GCU) researchers have received a £1.8m grant to examine the effectiveness of a new way of improving and maintaining walking ability in people who suffer from the painful and disabling symptoms of early rheumatoid arthritis.

Rheumatoid arthritis is a chronic autoimmune disease that attacks multiple joints throughout the body. More than 90% of people with rheumatoid arthritis develop symptoms in the foot and ankle, with resulting difficulties in walking.

Many people with rheumatoid arthritis are unable to walk far or fast, and often struggle with mobility tasks such as climbing stairs and walking on uneven ground.

GCU researchers in musculoskeletal health, Professor Martijn Steultjens and Dr Gordon Hendry, will lead the investigation to evaluate whether rehabilitation of walking through repetitive-task training using a walking circuit combined with behavioural approaches will help to improve the physical function of people suffering from early rheumatoid arthritis. They will work with partners at Keele University, King’s College London, Salford University and the University of Glasgow.

During the first two years of diagnosis, patients usually receive medication to control inflammation and may be referred for physiotherapy and/or podiatry for stretching and strengthening exercises and insoles. While some patients improve, many continue to suffer from foot pain, walking difficulties and problems performing daily activities.

The research team will use new gait rehabilitation techniques to help people walk with improved posture, balance and stability. Gait rehabilitation has been proven to help people suffering from the effects on mobility of neurological conditions such as stroke, multiple sclerosis, and Parkinson’s disease.

This new five-year study, funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, will establish whether the gait rehabilitation results in any additional benefits compared to usual treatment alone in a randomised trial.

The GREAT study (Gait Rehabilitation in Early Arthritis Trial) will take the form of an initial feasibility study involving patients from NHS regions in Scotland and England to fine-tune the gait rehabilitation intervention package and to identify the best way to measure its effectiveness, followed by a large trial to investigate whether gait rehabilitation adds benefits to usual care and to establish whether or not gait rehabilitation should be offered to all people with early rheumatoid arthritis.

Professor Steultjens said: “We are thrilled to have been awarded this substantial grant from NIHR. We are looking forward to working with our colleagues and patients to further develop the rehabilitation intervention and to then establish whether it is effective in improving patients’ lives.”