HOME EXERCISE AND COMPLIANCE IN INFLAMMATORY RHEUMATIC DISEASES - A PROSPECTIVE CLINICAL-TRIAL

Objective. To survey and to compare the one year effects of dynamic mu scle training and progressive muscle relaxation as home exercise for p atients with inflammatory rheumatic diseases; and to identify predicto rs for compliance with a longterm home exercise regimen. Methods. Fift y-four patients (mean age 54 yrs, mean symptom duration 14 yrs) were a ssessed for health related quality of life, exercise motivation, joint tenderness, and physical capacities. After randomization into 2 group s, every patient was instructed on one occasion in a 30 min program of either dynamic training or muscle relaxation to carry out at home, 5 times a week during 3 months, and then 2-3 times a week for another 9 months. Results. Seventeen patients in each group completed the one ye ar exercise protocol, while 10 from each group did not. Compliance wit h the one year exercise regimen seemed to be predicted by high self-ef ficacy for exercise, regular range-of-motion exercises before the inte rvention, and being unmarried. After one year, minor improvements in p hysical effect (p less than or equal to 0.05) and work effect (p less than or equal to 0.05) were found in the dynamic training group, while minor improvements in pain effect (p less than or equal to 0.05), emo tional reactions (p less than or equal to 0.05), and arm endurance (p less than or equal to 0.01) were found in the muscle relaxation group. No differences between the groups regarding changes in health status, joint tenderness, or physical capacities during the intervention peri od were found. Conclusion. These results may improve the selection of patients for home exercise, and form a basis for improved administrati on of home exercise programs.