RESEARCH - Effect of a high-intensity weight-bearing exercise on damage progression in RA

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Arthritis Rheum. 2005 Jun 2;53(3):410-417 [Epub ahead of print]

Effect of a high-intensity weight-bearing exercise program on radiologic

damage progression of the large joints in subgroups of patients with

rheumatoid arthritis.

Munneke M, de Jong Z, Zwinderman AH, Ronday HK, van Schaardenburg D,

Dijkmans BA, Kroon HM, Vliet Vlieland TP, Hazes JM.

Leiden University Medical Center, Leiden, and Radboud University Nijmegen

Medical Centre, Nijmegen, The Netherlands.

OBJECTIVE: To investigate whether a high-intensity exercise program

accelerates the rate of radiologic damage of the large joints in predefined

subgroups of patients with rheumatoid arthritis. METHODS: The data of 277

participants in a 2-year randomized controlled trial, comparing the effects

of high-intensity exercises with usual care, were used. Linear regression

analysis was used to test which predefined variables at baseline (age,

disease duration, disease activity, physical capacity, functional ability,

joint damage) modified the effect of high-intensity exercise on the

progression of radiologic damage of the large joints over 24 months.

RESULTS: Baseline radiologic joint damage was the only variable associated

with the effect of high-intensity exercise on joint damage progression in

large joints. In a subgroup of 218 patients with no or little joint damage

(defined as Larsen score </=5; 80% of our study population) the proportions

of patients with an increase in joint damage were similar for the exercise

and usual-care group (35% versus 36%, risk ratio [RR] 1.0 [0.7-1.4]; P = not

significant), whereas, in a subgroup of 59 patients who already had

extensive damage of large joints (defined as Larsen score >5) the proportion

was significantly higher in the exercise group (85% versus 48%, RR 1.8

[1.2-2.6]; P < 0.05).

CONCLUSION: High-intensity weight-bearing exercises appear to accelerate

joint damage progression in patients with preexisting extensive damage.

Patients with extensive large joint damage should, therefore, be advised to

refrain from activities excessively loading the damaged joints.

PMID: 15934121

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5934121 & dopt=Abstract

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