Effect of intensive exercise on patients with active rheumatoid arthritis:a randomised clinical trial

Objective-To investigate the effects of a dynamic, intensive exercise regim en on pain, disease activity, and physical functioning in active rheumatoid arthritis (RA). Methods-64 patients with RA with a mean age of 60 (13) years and mean disea se duration of 8 (8) years, admitted to hospital because of active disease, were randomly assigned to an intensive exercise programme or to a conserva tive exercise programme during their period in hospital with a mean length of 30 (14) days. The intensive exercise programme consisted of knee and sho ulder dynamic and isometric muscle strengthening exercises against resistan ce five times a week and conditioning bicycle training three times a week a nd was supplemental to the conservative exercise programme of range of moti on and isometric exercises. Indices of disease activity, pain, muscle stren gth, and functional ability were assessed at 0, 3, 6, 12, and 24 weeks by a blinded observer. Results-The medical treatment during the study was the same in both groups. Both groups improved in measures of disease activity, differences between groups were not statistically significant. The mean improvement in disease activity score at 24 weeks in the intensive and conservative exercise group was -1.4 (1.5) and -0.7 (1.4), respectively. Measures of physical function ing improved significantly for patients in the intensive exercise group, an d differences between groups were statistically significant for measures of muscle strength. Conclusion-A short term intensive exercise programme in active RA is more e ffective in improving muscle strength than a conservative exercise programm e and does not have deleterious effects on disease activity.