Bone Abstracts

Introduction: Physical exercises improve muscle strength, aerobic capacity and bone density in patients with rheumatoid arthritis (RA). However, some physicians fear to recommend the intensive exercises. The aim of the study is to compare the efficacy of two 6-month exercise programs in patients with early RA.

Methods: Fifty-one patients with early RA were randomized into 3 groups. At hospital stage 15 patients underwent ten high-intensity dynamic exercises using gym apparatus Enraf-Nonius for 45–60 min, including aerobic part (En-Cardio) and 18–20 muscle-strengthening exercises (En-Dynamic Track), 18 patients – ten therapeutic exercises for joints for 45 min under the supervision of a trainer. At outpatient stage the exercises lasted for 6 months three times a week. Eighty patients received only drug therapy (control). Tender (TJC) and swollen joint count (SJC), pain on 100 mm VAS, ESR, DAS28, HAQ, RAPID3, the average powers of knee extension and ankle flexion by EN-TreeM movement analysis were evaluated at baseline and at 6 months.

Results: After 6 months in the both exercise groups there were statistically significant differences from the control group in most parameters (P<0.05). Efficacy of the intensive gym exercises was higher than the therapeutic exercises by TJC, HAQ, RAPID3 (P<0.05). After 6 months in the gym group TJC decreased by 62.0%, SJC – by 56.3%, ESR – by 54.8%, pain – by 60.7%, DAS28 – by 0.99±0.14, HAQ – by 0.91±0.33, RAPID3 – by 5.22±1.25, the extension power of a weaker knee increased by 74.7%, the flexion power of a more affected ankle joint – by 71.8% (P<0.01). Most patients, who regularly did exercises, had low disease activity (66.7% in the gym group and 57.1% in the therapeutic exercises group vs 36,7% in the control group, P<0.05).

Conclusion: The both exercise programs increase functional status, quality of life and power of motion without detrimental effect on disease activity.