Efficacy of rehabilitation interventions in rheumatic conditions

All industrialized nations are facing a crisis in health care
financing. Rising expectations coupled with increasing
specialization and technologic capacities have forced health care
payers to examine their assumptions and to seek data on the
outcomes of medical interventions. Clinical investigators who have
been taught to use randomized controlled trials that evaluate
efficacy under experimental conditions have been redirected toward
studies that can help answer health policy questions. Such studies
examine the effectiveness of interventions in more realistic
settings on a richer array of patient-centered outcomes such as
function and consider cost effectiveness and relative cost
effectiveness. Rehabilitation interventions, which are by and large
pragmatic, have never had a strong scientific basis grounded in
controlled trials, and this lack of evidence has put tremendous
pressure on clinicians to justify their practices. In this article,
we review the recent literature on effectiveness of rehabilitation
interventions in rheumatic disorders.