Rheumatologic Disease

Rheumatism or rheumatic disorder is an umbrella term for conditions causing chronic; often intermittent pain affecting the joints and/or connective tissue. The study of, and therapeutic interventions in, such disorders is rheumatology. The term “rheumatism”, however, does not designate any specific disorder but covers at least 200 different conditions. Sources dealing with rheumatism tend to focus on arthritis; but “rheumatism” may also refer to other conditions causing chronic pain, grouped as non-articular rheumatism.
Many rheumatic disorders of chronic, intermittent joint pain have historically caused by infectious diseases. Their etiology was unknown until the 20th century and not treatable, like Lyme disease; coccidiomycosis or Valley fever and Chikungunya in India and a myriad of causes for postinfectious arthritis as reactive arthritis like, for example; the once very common rheumatic fever after Group A Streptococcus infection up to the rare Whipple’s disease.

Rheumatoid arthritis or axial spondylarthritis

Wearables are using by patients with rheumatologic disease; research has indicated that clinicians can use activity tracker data for flare assessment; according to an expert here at the Congress of Clinical Rheumatology. “There have several studies that looked at whether patients who had clinician-confirmed rheumatoid arthritis or axial spondylarthritis could identify when they were going to flare based upon changes in the number of steps,” said Judith A. James, MD, Ph.D.

James described published research by Jacquemin and colleagues who studied patients with RA (n=91); axial spondylarthritis (n=79) who wore an activity tracker watch every day for 3 months. She noted these patients “weren’t the sickest of the sick,” rather they had the well-controlled disease. Physical activity as daily steps, total activity duration and whether the activity was moderate to vigorous, James said.

Self-reported flares frequent

Patients were able to see their own activity through the activity tracker watch app. Additionally, through a secure messaging app, each day patients would report flares, pain, global assessment and number of steps. Self-reported flares frequent, and patients reported “11 days out of 90 they had symptoms that they indicative of their flares,” she said. “Flares that lasted more than 3 days with less weekly physical activity, decreased number of steps by close to 1,000 to 1,500, 12% to 21% relative decrease in steps and over 1 hour less in weekly activity,” James said.

They are definitely going to seeing more about integrating wearable information into studies that are done but also patients are bringing us their wearable information. “One of the things I found very striking is that there is an ICD-10 code if you put wearables into your [EMR].” More research will do using wearables including technology to track sleep patterns, heart rate variability, and activity, she said.