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Newer rehabilitation therapies: strategies in chikungunya chronic arthralgia

Rodrigo Pegado, Antonio FL Cavalcante and Edgard Morya
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DOI: https://doi.org/10.7861/clinmedicine.20-1-119a
Clin Med January 2020
Rodrigo Pegado
Federal University of Rio Grande do Norte, Santa Cruz, Brazil
Roles: Associate professor for graduate programme in rehabilitation science
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Antonio FL Cavalcante
Federal University of Rio Grande do Norte, Santa Cruz, Brazil
Roles: Graduate student in rehabilitation science
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Edgard Morya
Santos Dumont Institute, Macaíba, Brazil
Roles: Research coordinator
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Editor – Pathak et al looked over epidemiology, immunopathogenesis and management of chikungunya arthritis and reported several medication treatments in acute and chronic phase, however there is no discussion of physical rehabilitation.1,2

Since chikungunya could be considered as a neglected tropical disease, potentially affecting over 1 billion people, additional supportive managements should also be investigated to establish more strategies to prevent arthralgia and increase functionality.3–5 As in other rheumatic diseases, the recommended managements for chikungunya aim to prevent disability, unproductive work and secondary manifestations.6–8 The chronic chikungunya arthralgia/arthritis symptoms suggests an immune mechanism to medication treatments, however the growing scientific evidences of physical rehabilitation improving functionality and quality of life should be more explored at the managements.6 The World Health Organization and several societies of rheumatology recommend rehabilitation interventions in all phases of chikungunya, and include exercises, stretching, manual therapy and aquatic physical therapy.9,10 Moreover, two recent trials suggest novel approaches of rehabilitation therapies with transcranial direct current stimulation and pilates to reduce pain and improve functionality.4,11 The long-term burden of persistent arthralgia negatively impacts the public health system, economically active people and quality of life.10

Therefore, the association between pharmacological and physical rehabilitation could enhance the chikungunya management efficiency, decreasing chronic pain symptoms and treatment abandonment. Scientific evidence of several healthcare fields should support the development of a more complete chikungunya guideline to properly adjust to the individual patient needs, causing significant changes to their quality of life and general functionality.

  • © Royal College of Physicians 2020. All rights reserved.

References

  1. ↵
    1. Pathak H
    , Mohan MC, Ravindran V. Chikungunya arthritis. Clin Med 2019;19:381–5.
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    1. Krishnamurthy V
    . Chikungunya arthritis. Indian J Rheumatol 2008;3:91–2.
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    , Mores CN. A review of chikungunya virus-induced arthralgia: Clinical manifestations, therapeutics, and pathogenesis. Open Rheumatol J 2016;10:129–40.
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    1. Silva-filho E
    , Okano AH, Morya E, et al. Neuromodulation treats chikungunya arthralgia: a randomized controlled trial. Sci Rep 2018;8:16010.
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    1. de Souza CG
    , da Costa JF, de Sousa Dantas D, et al. Evaluation of pain, functional capacity and kinesiophobia in women in the chronic stage of chikungunya virus infection: A cross-sectional study in northeastern Brazil. Acta Trop 2019;199:104853.
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    1. Hoarau J-J
    , Jaffar Bandjee M-C, Krejbich Trotot P, et al. Persistent chronic inflammation and infection by chikungunya arthritogenic alphavirus in spite of a robust host immune response. J Immunol 2010;184:5914–27.
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    1. Rohekar S
    , Pope J. Assessment of work disability in seronegative spondyloarthropathy (SpA). Clin Exp Rheumatol 2010;28:35–40.
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    1. Amaral JK
    , Bilsborrow JB, Schoen RT. Brief report: the disability of chronic chikungunya arthritis. Clin Rheumatol 2019;38:2011–14.
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    1. Martõâ-Carvajal A
    , Ramon-Pardo P, Javelle E, et al. Interventions for treating patients with chikungunya virus infection-related rheumatic and musculoskeletal disorders: A systematic review. PLoS One 2017;12:1–15.
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    1. Marques CDL
    , Duarte ALBP, Ranzolin A, et al. Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 – Diagnosis and special situations. Rev Bras Reumatol Engl Ed 2017;57(Suppl 2):421–37.
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    1. de Oliveira BFA
    , Carvalho PRC, de Souza Holanda AS, et al. Pilates method in the treatment of patients with Chikungunya fever: a randomized controlled trial. Clin Rehabil 2019.
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Newer rehabilitation therapies: strategies in chikungunya chronic arthralgia
Rodrigo Pegado, Antonio FL Cavalcante, Edgard Morya
Clinical Medicine Jan 2020, 20 (1) 119-120; DOI: 10.7861/clinmedicine.20-1-119a

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Newer rehabilitation therapies: strategies in chikungunya chronic arthralgia
Rodrigo Pegado, Antonio FL Cavalcante, Edgard Morya
Clinical Medicine Jan 2020, 20 (1) 119-120; DOI: 10.7861/clinmedicine.20-1-119a
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