Date of Award

2002

Document Type

Scholarly Project

Degree Name

Master of Physical Therapy (MPT)

Department

Physical Therapy

First Advisor

Beverly Johnson

Keywords

Arthritis, Rheumatoid -- therapy; Boron -- therapeutic use

Abstract

Rheumatoid arthritis is a progressive, destructive and chronic, inflammatory disease of the joint synovium. Signs and symptoms include pain, limited range of motion, swelling, and tenderness, which may progress to deformity. These manifestations may limit dexterity, independent living, and the overall well being of an individual. Living with daily restrictions proves to be a psychologically distressing experience.

An increase in the dietary boron level of laboratory rats has shown to have a positive effect on the range of motion in their involved joints. This concept was tested on a human subject at the United States Department of Agriculture's Human Nutrition Research Center in Grand Forks, North Dakota over a six-month period from January 9th to June 19th, 2001. Joint involvement was assessed using goniometric measurements, a Poly Arthritis form, along with palpation of 16 fibromyalgic points. Subjective information was compiled regarding subject's level of pain, stiffness, bogginess, and soreness. The subject was measured on a consistent day and time each week. The study was conducted under the direction of Dr. Curtiss Hunt at the Human Nutrition Research Center and Beverly Johnson PT, MS at the University of North Dakota Department of Physical Therapy. Institutional Review Board approval was obtained, and inter-rater and intra-rater reliability were established prior to testing. A standardized verbal instruction regimen, to guide the subject and to encourage her to give her maximal effort during measurements, was used.

With an increased intake of boron, a significant influence on the range of motion was predicted. It was found, however, the active number of joints for this subject remained relatively constant, proving bogginess and soreness/sensitivity to palpation to still be present. However, the subjective rating of pain, fibromyalgic points, and hours of morning stiffness decreased with boron deprivation. By analyzing the range of motion statistics, 21 out of 64 tested motions were found to display changes in the measurements of dexterity-related joints for an individual with rheumatoid arthritis between boron supplementation and deprivation. A general increase was noted with boron supplementation, whereas a decrease was noted in the range of motion with boron deprivation.

The purpose of this case report was to analyze the effect of boron supplementation and deprivation and to aid in improving the pathological related signs and symptoms of an individual with rheumatoid arthritis. The potential to decrease the clinical manifestations and reduce the psychological stress of living with a chronic illness would benefit individuals with rheumatoid arthritis.

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