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THU0595 Physical Activity and Rheumatoid Arthritis, A Systematic Review
  1. F. Verhoeven1,2,
  2. N. Tordi3,
  3. C. Prati1,2,
  4. C. Demougeot4,
  5. F. Mougin3,
  6. D. Wendling1,5
  1. 1Rhumatologie, CHRU de Besançon
  2. 2EA 4267 “Fonctions et Dysfonctions Epithéliales”, FHU INCREASE, Faculté de Médecine-Pharmacie
  3. 3UPFR des sports, université de Franche Comté
  4. 4EA 4267 “Fonctions et Dysfonctions Epithéliales”, FHU INCREASE, Faculté de Médecine-Pharmacie
  5. 5EA 4266 “Agents Pathogènes et Inflammation”, Faculté de Médecine-Pharmacie, 25030 Besançon, France

Abstract

Background Rheumatoid Arthritis (RA) is the most common chronic inflammatory Rheumatism characterized by increased cardiovascular risk. In the general population, WHO proposes specific recommendations on the type of physical activity (PA) to achieve in the context of this cardiovascular risk. In RA patient, the place of PA is not highlighted to take care of the cardiovascular risk.

Objectives The aim of this work is to provide the available data about the effects of the PA in RA

Methods Systematic review of the literature on PubMed database with the following keywords: “physical activity”, “motor activity”, “Physical exercise” and “Rheumatoid arthritis”. We focused to the studies in humans older than 18 years old and written in English. We identified 401 references, 256 were preselected and 49 were relevant for the analysis.

Results RA is responsible for a greater inactivity highlighted with subjective measures (questionnaire) and with objective measures as the total energy expenditure or the accelerometer. Physical activity (PA) reduces significantly cardiovascular risk and DAS28. Physical inactivity and disease activity are correlated (RR 1.65 of inactivity as DAS28>5.1). At the vascular level, it improves endothelial function (improve antioxidant mechanisms and increase eNOS activity) and slows atherosclerosis. At the bone level, it slows radiographic progression of small joints but worsens the radiographic damages of big joints. PA slows bone mineral density loss at the femoral neck (0% of median change of hip bone mineral density versus 1% in the control group after 1 year, p<0.05) but have no effects on the spine. Finally, the practice of PA enhances quality of life (measured with the World Health Organization Quality of Life brief form) and decreases the perception of pain (VAS). The suggested type of PA is mainly an endurance activity. The majority of interventions are limited in time (4 weeks) with aerobic activities (running, cycling) 60 minutes, 5 days a week. Resistance activity programs also show an improvement in inflammation and muscle strength. Obstacles to the practice of AP are linked either to the patient with a lack of motivation and information, or to practitioners who have limited knowledge of the beneficial effects of the PA and its feasibility. Thus promotion of the PA in RA is very restricted (28% of patients). The solutions are many. At the patient level, one would improve their information on the beneficial effects of the PA. At the practitioner level, one should promote more systematically the PA. Finally, the supervised character of the PA like the monitoring program on internet would increase compliance

Conclusions The beneficial effects of PA on RA are multiple and its practice should be promoted as part of the patients therapeutic education.

Disclosure of Interest None declared

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