Background Rheumatoid arthritis (RA) is associated with adverse changes in body composition and physical function that persist despite pharmaceutical treatment. Randomised control trial evidence has shown that Progressive Resistance Training (PRT) is safe and efficacious in restoring lean mass and function in patients with RA. We set up our own PRT programme for RA patients to explore whether similar results could be achieved in an NHS setting.
Methods RA patients were invited to attend a PRT programme of six, weekly class held under the supervision of a Senior Physiotherapist. Newly diagnosed and established RA were included. The exercises used within the circuit are: wall slides, chest press, leg extension, rowing, balance board work, triceps extensions, bicep curls, clam, bridging, standing calf raises and step ups. Classes included up to 10 patients at a time. Data collected at induction and after six weeks included demographics, BMI, percentage body fat, grip strength, 60 second Sit to Stand test, HAQ and FACIT (fatigue) scores. After the six-week PRT programme patients were encouraged to continue at home or referred to their local gym.
Results Of 34 RA Patients invited, 27 started and 21 completed the 6 week PRT course. Mean age 54 (range 17–78) years; 71% F; 50% RF positive. 11 (32%) patients were diagnosed within 3 months of starting the class. There was no difference in results between recently diagnosed and established RA patients.
After six weeks there was a significant improvement in: HAQ mean (range) 1 (0–2.9) vs 0.8 (0–2.5) p=0.03; Body Fat Composition mean (range) 38.0% (21.5%>51%) vs 36.9% (26.3%>48.2%) p=0.02; Sit to Stand mean (range) 20.0 (8–36) vs 23 (9–42) p=0.02. There was a trend towards improvement mean (range) in: handgrip strength 22.0 (2–54) vs 25.8 (5–54) p=0.21 and FACITF score 29.5 (18–49) vs 35.6 (19–49) p=0.05.
Conclusions We present an effective model for PRT workable in the NHS, which encourages patient to take control of their own exercise regimes. The class setting fosters motivation, confidence and a belief in exercise as part of effective treatment. This brief intervention was associated with significant improvement in various aspects of physical function, Grip strength, HAQ and Fatigue scores.
Disclosure of Interest None declared
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