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a Department of
Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands, b Department of Medical Statistics, Leiden
University Medical Centre, c Department of Rheumatology, Free University
Hospital Amsterdam, Amsterdam, The Netherlands, d Department
of Physical Therapy, Leiden University Medical Centre
Correspondence to: Dr C H M van den Ende, Leiden University Medical Centre, Department of Rheumatology, C4-R, Postbox 9600, 2300 RC Leiden, The Netherlands Email: e.vandenende{at}nivel.nl
Accepted for publication 9 February 2000
OBJECTIVE
To
investigate the effects of a dynamic, intensive exercise regimen on
pain, disease activity, and physical functioning in active rheumatoid
arthritis (RA).
METHODS64 patients
with RA with a mean age of 60 (13) years and mean disease duration of 8 (8) years, admitted to hospital because of active disease, were
randomly assigned to an intensive exercise programme or to a
conservative exercise programme during their period in hospital with a
mean length of 30 (14) days. The intensive exercise programme consisted
of knee and shoulder dynamic and isometric muscle strengthening
exercises against resistance five times a week and conditioning bicycle
training three times a week and was supplemental to the conservative
exercise programme of range of motion and isometric exercises. Indices
of disease activity, pain, muscle strength, and functional ability were
assessed at 0, 3, 6, 12, and 24 weeks by a blinded observer.
RESULTSThe medical
treatment during the study was the same in both groups. Both groups
improved in measures of disease activity, differences between groups
were not statistically significant. The mean improvement in disease
activity score at 24 weeks in the intensive and conservative exercise
group was 
1.4 (1.5) and 0.7 (1.4), respectively. Measures of
physical functioning improved significantly for patients in the
intensive exercise group, and differences between groups were
statistically significant for measures of muscle strength.
CONCLUSIONA short
term intensive exercise programme in active RA is more effective in
improving muscle strength than a conservative exercise programme and
does not have deleterious effects on disease activity.
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