Management of arthritis patients after functional deterioration

Hospitalization in arthritis patients is indicated when the disease flares or when joint replacements are to be placed. Conservative treatment aims to control disease activity and to reduce pain. Joint replacement is indicated when pain or functional limitations due to a destroyed joint impair the activities of daily living. Immobility, preceding and during hospitalization, leads to a deterioration of muscle strength and mobility of joints, resulting in limited physical functioning, which can end up in a vicious circle. Restoring function by improving the physical fitness immediately after hospitalization is a major challenge. The physical improvement should ultimately lead to an improved quality of life. Some patients will have a severe decrease in functional capacity during hospitalization and as a consequence they will not be able to be discharged to go home when their medical condition is stable again. In those cases, a rapid recovery of function and physical condition is warranted. We hypothesized that a dedicated and short training, immediately after hospitalization, in an extramural inpatient setting like a resort or hotel could lead to a faster and better functionality for those patients. In this thesis we report on our studies on this hypothesis. We studied the effects and the cost‐effectiveness of such a training program in RA and OA patients hospitalized for a RA flare or for elective TKA or THA.