COMPARISON OF HIGH AND LOW-INTENSITY TRAINING IN WELL-CONTROLLED RHEUMATOID-ARTHRITIS - RESULTS OF A RANDOMIZED CLINICAL-TRIAL

Objective-To investigate the benefit of intensive dynamic exercises in comparison to range of motion (ROM) and isometric exercises in rheuma toid arthritis. Methods-100 consecutive rheumatoid arthritis patients on stable medication were randomly assigned to (1) intensive dynamic g roup exercises which included full weight bearing exercises and condit ioning exercises on a stationary bicycle while the heart rate was main tained at 70-85% of the age predicted maximum heart rate, (2) range of motion (ROM) exercises and isometric exercises in a group, (3) indivi dual isometric and ROM. exercises, and (4) home instructions for isome tric and ROM exercises. Variables of physical condition, muscle streng th, joint mobility, daily functioning (HAQ), and disease activity were assessed before and after the 12 week exercise course, and 12 weeks t hereafter. An intention to treat analysis was performed. Results-Incre ases in aerobic capacity (n = 77), muscle strength, and joint mobility in the high intensity exercise programme were respectively 17%, 17%, and 16% and differed significantly from the changes in aerobic capacit y, muscle strength, and joint mobility in the other exercise groups. N o deterioration of disease activity was observed. Twelve weeks after d iscontinuation of the exercise course the gain in physical capacity ha d disappeared. Conclusions-Intensive dynamic training is more effectiv e in increasing aerobic capacity, joint mobility, and muscle strength than ROM exercises and isometric training in rheumatoid arthritis pati ents with well controlled disease.