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Running head: RHEUMATOID ARTHRITIS

RCLS 245, Therapeutic Recreation for Individuals with Disabilities


Katherine Campbell
February 26, 2015
IFC Write-Up Based on Diagnosis

RHEUMATOID ARTHRITIS

Description:
With individuals that have rheumatoid arthritis (also known as RA), it is said that the
immune system, for some unknown reasons, attacks a persons own cells inside the joint capsule
(Porter & Burlingame, 2010, p. 116). Porter and Burlingame (2010, p. 116) say that this causes
inflammation at the synovium due to white blood cells that travel there. The authors Porter and
Burlingame (2010, p. 116) say that this inflammation is called synovitis, which results in
swelling, redness, warmth, and pain; these are the typical symptoms of rheumatoid arthritis.
Porter and Burlingame (2010, p. 116) also discuss that while during this inflammation process,
the cells of the synovia begin to grow and divide abnormally; in return this makes the normally
thin synovia thick, which results in a joint that becomes puffy and swollen to the touch. With the
progression of RA, unfortunately, cartilage and bone get destroyed, because of these abnormal
synovia cells. In return, the muscles, ligaments and tendons that are surrounding the joint
become weak and unable to function normally (Porter & Burlingame, 2010, p. 116). All of these
effects that I have stated from our book lead to serious discomfort, and even deformities, in
regards to the joints. Porter and Burlingame (2010, p.116) say that early diagnosis is critical
because studies have shown that damage to the bones begins within the first couples of years that
a person has rheumatoid arthritis. There are three factors that Porter and Burlingame (2010,
p.116) talk about that can be the cause of RA, genetic factors, environmental factors, hormones
or even a combination of the three. Porter and Burlingame (2010, p.116) list the symptoms that
individuals with rheumatoid arthritis might experience, such as anemia, depression, fatigue,
functional limitations, malaise, and impaired range of motion. There are secondary problems that
arise, such as a decrease in cardiopulmonary endurance, joint deformity, muscle atrophy,
osteoporosis, pain, psychological changes, sexual dysfunction and bone loss (2010, p.117).

RHEUMATOID ARTHRITIS

Knowing that RA is a chronic inflammatory disorder, it typically affects the small joints
in a persons hands and in their feet (Mayo Clinic Staff, 2014). The mayo clinic staff (2014) also
adds that RA can sometimes affect other organs of the body such as, the eyes, skin, lungs, and
blood vessels. Reading over the mayo clinic staffs (2014) definition of RA, they note that even
though rheumatoid arthritis can occur at any age, it will typically begin after the age of forty, and
that this disorder is more common among women. In regards to how many people in the United
States have RA, the Arthritis Foundation (2015) states that About 1.5 million people in the
United States have rheumatoid arthritis (RA). While reading WebMDs (2013, p. 3) article on
how to prevent joint damage, they talk about exercising and just how important that is,
Exercise! You can exercise without causing joint damage. In fact, exercise has the opposite
effect -- regular exercise makes joints stronger. Your doctor will help you with an exercise plan
that is safe, effective, and personalized for your fitness level and condition.
Body Functions:
b280 Sensation of Pain.
This code states that it should be used for those that have sensation of unpleasant feeling
indicating potential or actual damage to some body structure (Porter & Burlingame, 2010, p.
198).
Discussion of Relevancy to Diagnosis
This is critical for those individuals that have RA because they experience chronic pain
and inflammation. People with RA after progression, can experience damage to their bones
which will result in deformities. Reading through more specific codes in this section of b280
Sensations of Pain, one could code an individual expressing joint pain as the code b28016 Pain

RHEUMATOID ARTHRITIS

in Joints (Porter & Burlingame, 2010, p.199) which talks about the small or big joint pain that
individuals feel from potential or actual damage due to the disease.
b455 Exercise Tolerance Functions.
This code is talks about functions that are related to respiratory and cardiovascular
capacity as required for enduring physical exertion. Inclusions: functions of physical endurance,
aerobic capacity, stamina, and fatigability (Porter & Burlingame, 2010, p.212).
Discussion of Relevancy to Diagnosis
I found this code to be important because exercise is crucial for those suffering from RA.
Due to the pain and stiffness from RA, a question that could be asked is, can some individuals
tolerate exercising? Some individuals have limited range of motion, which can make it more
difficult for some people to exercise. Porter and Burlingame (2010, p.117) say that fatigue is a
common problem because of the increased time and effort required while undertaking daily
tasks; this could come into effect even while exercising. Just to go more specific with this code,
code b4552 Fatigability could be used if someone is expressing fatigue due to any level of
exertion because of RA (Porter & Burlingame, 2010, p. 212).
b710 Mobility of Joint Functions.
This code discusses the range and ease of the movement of a joint. Inclusions: functions
of mobility of single or several joints, vertebral, shoulder, elbow, wrist, hip, knee, ankle etc.
(Porter & Burlingame, 2010, p. 228).
Discussion of Relevancy to Diagnosis
I found this code to be relevant for those entities with RA. A person can discuss whether
it is a single joint or maybe several joints they could be having difficulties with when moving
because of their symptoms associated with RA.

RHEUMATOID ARTHRITIS

Activities and Participation


d240 Handling Stress and Other Psychological Demands
This code discusses how to carry out simple or even complex and coordinated actions to
manage and control the psychological demands required to carry out tasks demanding
significant responsibilities and involving stress, distraction, or crises, such as driving a vehicle
during heavy traffic or taking care of many children (Porter & Burlingame, 2010, p. 271).
Discussion of Relevancy to Diagnosis
This code is relevant for those with Ra because, it would be an excellent one to use due to
the stress that comes with having rheumatoid arthritis. Individuals with RA have pain and
stiffness so this can cause stress when having to take on responsibilities like cleaning or taking
care of children and even in the middle of a traffic jam. Emotional health is vital, so learning
how to handle stress will come in handy throughout life.
d175 Solving Problems
This code talks about how to solve questions or situations by identifying and examining
issues, develop options and solutions, evaluate potential effects of solutions, and executing a
chosen solution, such as in resolving a dispute between two people (Porter & Burlingame, 2010,
p. 265).
Discussion of Relevancy to Diagnosis
A person suffering from RA might need to solve an issue regarding lifting or reaching,
cleaning, any daily task or even an emotional problem, and possibly using different methods on
how to go about that, due to their pain and stiffness. Individuals with RA can develop solutions
that can be easier on them when needing to solve a problem.
d150 Acquiring a Skill

RHEUMATOID ARTHRITIS

This code is about how to develop the basic skills as well as the complex skills, by
integrated sets of actions or tasks so as to initiate and follow through with the acquisition of a
skill, such as manipulating tools or playing games like chess (Porter & Burlingame, 2010, p.
263).
Discussion of Relevancy to Diagnosis
Individuals with RA can be treated for acquiring skills and learn new ones that can help
them function better with their disease. They can learn how to exercise in new ways, learn how
to play games differently, even learning technology skills like how to use Dragon on the
computer if their joints get too deformed and it is difficult for them to write.
Environmental Factors
e130 Products and Technology for Education
This environmental code talks about the equipment, products, processes, methods, and
technology used for acquisition of knowledge, expertise, or skill, including those adapted or
specially designed (Porter & Burlingame, 2010, p. 345).
Discussion of Relevancy to Diagnosis
In regards to what I had said earlier about using Dragon on the computer, this is a perfect
example for this code when talking about facilitators, because Dragon can be used for writing
papers, and even emailing professors. There are different skills to learn and different methods of
technology and equipment that can be used for furthering education for those individuals with
RA.
e235 Human-Caused Events

RHEUMATOID ARTHRITIS

This last code that I will be describing, talks about the natural events that are caused by
humans. It can range from anything like, destruction of socials infrastructure, homes and lands,
environmental disasters, and land, water, or air pollution (Porter & Burlingame, 2010, p. 359).
Discussion of Relevancy to Diagnosis
I found this code to be of relevance because, for example, a human-caused event could
be a traffic jam; this would be a barrier for individuals with RA. It is important to mention this
because it could cause a lot of stress and even pain from sitting in traffic for long periods of time.

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8
References

Arthritis Foundation. (2015). Rheumatoid Arthritis. Arthritis Foundation. Retrieved February 18,
2015, from http://www.arthritis.org/arthritis-facts/disease-center/rheumatoid-arthritis.php
Mayo Clinic Staff. (2014, October 29). Rheumatoid Arthritis Definition. Mayo Clinic. Retrieved
February 18, 2015, from http://www.mayoclinic.org/diseases-conditions/rheumatoidarthritis/basics/definition/con-20014868
Porter, J., Burlingame, H. R. (2010). Recreational Therapy Handbook of Practice. (T. M.
Blaschko, Ed.). Enumclaw, WA: Idyll Arbor Inc.
WebMd. (2013). Preventing Joint Damage from Rheumatoid Arthritis. WebMd (pp.1-3).
Retrieved February 18, 2015, from http://www.m.webmd.com/a-to-z-guides/preventingjoint-damage-rheumatoid-arthritis?page=1