What are connective tissues
Any biological tissues with an extensive matrix that
- provide structure, support, and defense
- Transport material
- bind organs together
What do connective tissues consist of
- Cell fibres (collagen or elastic)
- Ground substance (water, fluid, protein)
What are the 6 types of connective tissue
- loose tissue
- fibrous tissue
- adipose tissue
- blood
- cartilage
- bone
What is loose tissue composed of? Example of this type of tissue?
collagen and elastin
Blood vessels, internal organs
What is fibrous tissue composed of? Example of this type of tissue?
mostly collagen, few elastin
Tenson, ligs
Many connective tissue diseases feature…
abnormal immune system activity
Is there a genetic component to autoimmune diseases?
yes
Is there an environmental component to autoimmune disease
yes: Pollution/pesticide infections medications can trigger the onset
Is there a behavioural component to autoimmune disease
Yes, smoking or stress can trigger the onset
Lupus is referred to as…
“A disease of a thousand faces”
What is the shape of the rash seen in lupus
Butterfly-shaped malar rash
What ethnicities does lupus effect most
- Asian
- African
- Hispanic
Lupus means what in latin
wolf
What does erythro mean in greek
red
What does systemic lupus effect
- Skin
- Lungs
- Kidney
- CNS
- Circulatory system
- Heart
- GI system
- muscle and joint
- Oral and nasal ulcers
What is needed for a systemic lupus classification
- Malar rash
- Discoid rash
- Photosensitivity
- Oral ulcers
- non-erosive arthritis
- Pleuritis or pericarditis
- Renal disorder
- Neurological disorder
- Hematologic disorder
- Immunologic disorder
- Positive antinuclear antibody test
What are the characteristics of non-erosive arthritis
- Transient
- Symmetrical
- Affecting small joints
- ## Less sever than RA
What are the neurologic clinical features of lupus
- Seizures = Psychosis - Behaviour/personality changes, depression - Cognitive dysfunction - Stroke - Peripheral neuropathy - Chorea (abnormal involuntary movement disorder) - Transverse myelitis
Up to ___% of patients with SLE develop lupus nephritis
50%
__% of SLE patients require a kidney dyalysis or transplant
10%
is the renal involvement of lupus normally symptomatic or asymptomatic
asymptomatic
What is the hallmark clinical feature of renal involvement in SLE
proteinuria
What is the most frequent cause of disease related death from lupus
Renal failure
What are some other symptoms of SLE
- Pain
- Severe fatigue
- memory loss
- Depression
What is the PT management of Lupus
- Pain management
- Therapeutic exercise and PA
- Patient education: energy conservation principles, joint protection principles, sun protection
What were the results of PA on those with lupus vs. control groups
- Positive effect on depression
- positive effect on CR capacity
- less fatigue
- no adverse effect on the SLE disease activity
What are the two energy conservation principles
- Prioritize - what activities are important to you, what activities can your friends and family help with
- Plan - Self monitory, balance exercise with rest, eat a well-balanced diet and avoid heavy metals
- Pace - Balance rest and activity, take breaks, have a routine, get a good nights sleep
- Posture - Maintain good posture, take standing breaks
What are the joint protection principles
- Respect for pain
- Balance activity and rest
- Avoid repetitive activities
- use larger, stronger joints for activities
- Avoid staying in one position for a prolonged period
- Maintain good joint alignment
- Maintain healthy body weight
- maintain good posture
What are the main non-pharmacologic intervention in the management of connective tissue disease such as SLE
- Pain control
- Physical activity
- Patient education
