Rehabilitation of patients with RA and the pharmacological treatment are the key elements of successful therapy. Rehabilitation is reducing pain, that is demonstrated in a systematic review done by Park et al. [
18], wherein all the analyzed data VAS scale was used for subjective pain assessment, and in all the studies, the statistically significant pain decreased among patients after rehabilitation. Disease activity assessment is a significant element of monitoring the condition of patients with RA. As a disease activity increases, patients’ functional problems increases, self- esteem and quality of life worsen, that was observed in our study based on differences between groups in KALU and HAQ- DI rates. The results showed that regardless of disease activity in DAS28, also in patients’ with exacerbation of the disease, the rehabilitation is needed and remains effective. This is confirmed by the fact that in both assessed groups the average DAS28 index and subjective pain level determined on the VAS scale decreased statistically significantly. Similarly, according to Gizińska et al. [
19], after rehabilitation of two groups of patients with high disease activity, statistically significant decreasing of DAS28 level and pain level measured by VAS scale was observed. Our study shows that high disease activity is not a contraindication for rehabilitation due to the fact that those patients get a significant increase in quality of life and life condition. The need and effectiveness of rehabilitation is confirmed in many studies based on the decreasing pain level and disease activity index [
20‐
26]. In the study of Sukharev et al. [
27], DAS28 level decreased after rehabilitation in all groups regardless of the rehabilitation program. In our study, also statistically significant changes in those parameters were observed
. Analysis of the level of CRP after 4 weeks rehabilitation indicated no statistically significant decrease, what is confirmed in a study done by Sadura-Sieklucka [
28]. However, Orlova’s [
21] research covering a 6-month rehabilitation period shows that there was a statistically significant decrease in the CRP level which may suggest the need to extend the rehabilitation time. Patients’ quality of life level in KALU and health assessment by HAQ-DI showed statistically significant improvement in both questionnaires. KALU questionnaire is an effective tool for assessing patients with rheumatoid arthritis quality of life [
17]. In research done by Kowalczyk et al. [
17], the mean score in KALU was 1.28 ± 0.55 with the average DAS28 result 5.09 ± 1.05. There was also a significant correlation between the DAS28 index and the KALU questionnaire, which is confirmed by our own research in the group with lower disease activity according to the DAS28 coefficient, a smaller average value of the KALU questionnaire was observed (i.e. DAS28 = 3.5 ± 0.6, KALU = 0.85 ± 0.47, and DAS28 = 5.0 ± 0.6, KALU = 1.45 ± 1.02). Decreasing DAS28 index after rehabilitation reflected also on the decreasing mean value of KALU questionnaire, and that indicates an improvement in the quality of life of patients after rehabilitation. In our study, the mean value of health condition index HAQ-DI also decreased. Rehabilitation significantly influence the improvement of patients health condition and quality of life [
29‐
31]. Research by Ghosh et al. [
32] revealed a high correlation between DAS28 level and the mean score of HAQ-DI questionnaire. In research done by Gizińska et al. [
19], it was observed that rehabilitation of patients with RA had a positive impact on the reduction of HAQ-DI. Regardless of the rehabilitation method used, the HAQ-DI mean score decreased from 1.82 ± 1.18 to 1.64 ± 1.19 and 2.72 ± 1.48 to 2.12 ± 1.30. This is confirmed by our own study, in both groups regardless the rehabilitation method, the decreasing of HAQ-DI was noticed from 0.74 ± 0.67 to 0.47 ± 0.48 and 1.03 ± 0.52 to 0.71 ± 0.53. The intensity of exercise had no impact on the quality of improvement of patients according to the HAQ-DI index. Studies revealed that exercises focused on improving muscle strength in patients with rheumatoid arthritis had statistically significant impact on achieved results even after 24 weeks [
31]. The review of the literature on the subject as well as the present research indicate that the progress in patient rehabilitation is not affected by factors such as disease activity according to the DAS28 indicator or the rehabilitation program [
24,
25,
27]. Rehabilitation based on various forms of physiotherapy or training programs gives different results, while all of them prove effective [
24]. To sum up, we may conclude that in the rehabilitation of RA patients, the key to success is the right choice of methods and forms of work with a specific patient.