A 4-week dynamic exercise program (DEP) improves functional status and quality of life in patients with rheumatoid arthritis (RA) compared with a standard joint rehabilitation program, French research reveals.
Dynamic exercise programs developed for patients with diseases such as chronic airway obstruction or coronary heart disease to reduce disability are now being used in the rehabilitation of RA patients, explain Anthan Baillet (Grenoble Teaching Hospital, Echirolles Cedex) and co-workers.
Previous studies evaluating DEP in RA were limited by methodologic bias, say the researchers, who therefore carried out a single-blinded randomized controlled trial to evaluate the functional, clinical, radiological, and quality of life outcomes of a 4-week DEP in 50 patients with RA.
The training program was designed to improve muscle strength, flexibility, endurance and balance. Exercises for the upper and lower limbs were performed five times a week in a gymnasium and hydrotherapy pool.
The researchers report that functional status, assessed by health assessment questionnaire (HAQ), did not differ between the groups at baseline but HAQ measurement improved throughout the length of the trial in the DEP group.
This improvement was greater in DEP than in the standard joint rehabilitation group at 1 month, after which the exercises were home-based and self-administered, but not at 6 months or 12 months.
The DEP also improved quality of life, measured by the Nottingham Health Profile (NHP), and aerobic fitness at 1 month, but the progress was not statistically significant thereafter.
In addition, dexterity and disease activity in 28 joints measure showed greater improvement in the DEP group than in the standard joint rehabilitation group but the differences were not significant.
Of note, radiologic evaluation did not demonstrate any deleterious effects of the DEP.
Baillet and team comment that after the first month “the patients could therefore no longer benefit from the group dynamic, explaining the reduction in effect of DEP on NHP,” they remark.
“Our study, based on stringent methodological procedure, provides evidence for quality of life improvement following DEP,” conclude the researchers in the journal Rheumatology.