EXERCISE THERAPY IN PATIENTS WITH RHEUMATOID-ARTHRITIS AND OSTEOARTHRITIS - A REVIEW

Exercise therapy in patients with rheumatoid arthritis (RA) or osteoar thritis (OA) is controversial, because both improvement and deteriorat ion of the patients' condition can be expected to occur. The literatur e was searched for studies on the outcome of exercise therapy in RA- a nd OA-patients. Twenty-four studies were identified, comprising nine c ontrolled studies. In the present review, these studies are critically summarized. It was found that controlled studies have only reported i mprovements or non-significant results; deterioration of the patients' condition has not been reported. With regard to specific modalities o f exercise therapy, it was found that aerobic exercise in RA-patients has been most thoroughly studied: improvements for specific categories of outcome (e.g., walking time and other sorts of observed disability ) have been repeatedly reported, while for other categories of outcome (e.g., pain) non-significant results have been consistently reported. Several methodological deficiencies (concerning randomization, blinde d evaluation and power) and assets (concerning compliance) in controll ed studies are noted and evaluated. It is concluded that, despite seve ral qualifications, the available evidence is in favor of exercise the rapy in RA- and OA-patients. Neglected areas of research, including co mparisons between subgroups of patients, are identified and suggestion s for future research are given.