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Aerobic exercise safe and effective for rheumatoid arthritis patients

Cardio-respiratory aerobic conditioning improves function, lessens joint pain

Researchers from the University of Grenoble Medical School in France determined that cardio-respiratory aerobic exercise is safe for patients with stable rheumatoid arthritis (RA). The team found that RA patients who exercised regularly had improved function, less joint pain, and greater quality of life. Full findings of the study are now available online and will publish in the July print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.

RA, a chronic inflammatory disease characterized by swollen joints, pain, stiffness, fatigue, and general malaise affects up to 1% of the global population, according to the World Health Organization (WHO). The Centers for Disease Control and Prevention (CDC) citing health-related quality of life (HRQL) studies found that RA patients were 40% more likely to report fair or poor general health and twice as likely to have a health-related activity limitation compared with those without arthritis.

The current study led by Athan Baillet, M.D., conducted an abstract search of relative medical journals for studies that researched RA patients and impact of aerobic exercise. The team analyzed 14 studies and meta-analysis included 510 patients in the intervention group and 530 in the control group. Participants in these studies had a mean age of 44-68 years and their RA disease duration was 1-16 years. Researchers compared HRQL, the Health Assessment Questionnaire (HAQ), joint count, and pain using a visual analog scale (VAS) among patients in the studies.

"Our results show that patients with stable RA would benefit from regular aerobic exercise," said Dr. Baillet. "Cardio-respiratory conditioning appears safe and its effects, while small, help to reduce joint pain and improve function." Researchers assessed the efficacy of exercise on RA symptoms using standardized mean differences (SMDs) which is the difference (between groups) of mean outcome variation from baseline/SD at baseline of aerobic exercises versus non-aerobic rehabilitation. Meta analysis of the research showed that exercise improved the post-intervention quality of life (SMD=0.39), HAQ score (SMD=0.24), and pain VAS (SMD=0.31). The difference in scores between those who exercised and those who had not are considered clinically meaningful by both patients and doctors noted the researchers.

The American College of Rheumatology states that exercise is beneficially for everyone, including those with RA, and currently recommends 150 minutes of moderate intensity aerobic activity each week. Safe forms of aerobic exercise, such as walking, aerobic dance, and aquatic exercise, help arthritis patients to control weight, and improve sleep, mood, and overall health.

"While past studies have indicated that RA patients are quite physically inactive, our study shows aerobic exercise to be a safe and beneficial intervention for this group. Further trials are needed to clearly determine the clinical impact of cardio-respiratory conditioning in the management of RA," concluded Dr. Baillet.

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Article: "Efficacy of Cardiorespiratory Aerobic Exercise in Rheumatoid Arthritis: Meta-Analysis of Randomized Controlled Trials." Athan Baillet, Nadine Zeboulon, Laure Gossec, Christophe Combescure, Louis-Antoine Bodin, Robert Juvin, Maxime Dougados, and Philippe Gaudin. Arthritis Care and Research; Published Online: February 23, 2010 (DOI: 10.1002/acr.20146); Print Issue Date: July 2010. http://www3.interscience.wiley.com/journal/123301378/abstract

This study is published in Arthritis Care & Research. Media wishing to receive a PDF of this article may contact healthnews@wiley.com.

Arthritis Care & Research is an official journal of the American College of Rheumatology, and the Association of Rheumatology Health Professionals, a division of the College. Arthritis Care & Research is a peer-reviewed research publication that publishes both original research and review articles that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with arthritis and related disorders, major topics are evidence-based practice studies, clinical problems, practice guidelines, health care economics, health care policy, educational, social, and public health issues, and future trends in rheumatology practice. For more information on Arthritis Care & Research, please visit http://www3.interscience.wiley.com/journal/123227259/grouphome/home.html.

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, Inc., with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or www.interscience.wiley.com.



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