Exercise programs recommended as standard for rheumatoid arthritis

Exercise programs designed to improve strength and stamina are safe and effective treatments for rheumatoid arthritis (RA), according to a new Cochrane Systematic Review. The researchers reviewed dynamic exercise program trials in RA patients and found moderate benefits associated with this type of treatment.

"Based on the evidence in this study, we would recommend aerobic capacity training combined with muscle strength training as routine practice for RA patients," said lead researcher Emalie Hurkmans of the Leiden University Medical Center in Leiden, Netherlands. "But we need more research to establish the recommended length and type of exercise programs, whether patients need to be supervised and if these programs are cost effective."

RA affects up to 1 in 100 people in Western countries, causing chronic pain and inflammation of the joints. There is currently no cure for the disease, so dynamic exercise programs are often recommended as a complement to drug therapy to try to improve physical function through physical exercise.

The researchers combined data from eight trials involving a total of 575 patients. The results reaffirm the previous study's findings that dynamic exercise programs are safe and have positive effects on aerobic capacity and muscle strength in RA patients, and when performed long term also have a positive effect on functional ability. However, the researchers say the benefits are only seen immediately after the intervention. They also suggest water-based programs may help to improve functional ability of patients.

"One important omission from this study is evidence for long term follow-up effects, so without further studies we can't rule out that the obtained effects vanish if exercise programs are not continued over long periods. There are also other types of exercise that weren't included in our review, such as flexibility and stability training, and it would be interesting to find out whether these also have positive effects," said Hurkmans.

October 6, 2009