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THU0591 Comparative Efficacy of Two Exercises Programs in Patients with Early Rheumatoid Arthritis: 6-Month Randomized Controlled Trial
  1. E. Orlova1,
  2. D. Karateev2,
  3. L. Denisov1,
  4. A. Kochetkov3,
  5. E. Nasonov4
  1. 1Laboratory of Clinical Trials
  2. 2Early Arthritis department, Research Institute of Rheumatology named after V.A. Nasonova
  3. 3Rehabilitation and Sport Medicine, Central Rehabilitation Hospital, Federal Medical Biological Agency
  4. 4Research Institute of Rheumatology named after V.A. Nasonova, Moscow, Russian Federation

Abstract

Background The patients with rheumatoid arthritis (RA) are less physically active than the general population [1]. Physical exercises improve muscle strength, range of movements, aerobic capacity and bone density in patients with RA [2–4]. However, some physicians fear to recommend the intensive exercises.

Objectives To compare the efficacy of two exercise programs in patients with early RA during 6 months.

Methods 51 patients with early RA (92,2% females, age of 18 to 53 years, disease duration of 2 to 17 months) were randomized into 3 groups. At hospital stage 15 patients underwent 10 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 – 10 therapeutic exercises for joints for 45 min under the supervision of a trainer. At outpatient stage the exercises lasted for 6 months 3 times a week. 18 patients received only drug therapy (control). Tender and swollen joint count, pain on 100-mm VAS, erythrocyte sedimentation rate (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 tender joint count, HAQ, RAPID3 (p<0,05).

Table 1

Adherence to the regular therapeutic exercises for 6 months was better (77,8%) then to the gym exercises (60,0%). Predictors of the regular high-intensity gym exercises were the young age (under 40 years) and the very early stage of RA. Most patients, who regularly did exercises, had DAS28 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).

Conclusions The both 6-month exercise programs reduce pain, increase functional status, quality of life and power of motion without detrimental effect on disease activity.

References

  1. van den Berg M.H. et al. J Clin Rheumatol 2007;13(4):181–6.

  2. Hurkmans E. et al. Cochrane Database Syst Rev 2009;4:CD006853.

  3. De Jong Z. et al. Clin Rheumatol 2009;28(6):663–71.

  4. Baillet A. et al. Arthritis Care Res 2010;62:984–92.

Disclosure of Interest None declared

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