High intensity exercise or conventional exercise for patients with RA?

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Ann Rheum Dis. 2004 Jul;63(7):804-8.

High intensity exercise or conventional exercise for patients with

rheumatoid arthritis? Outcome expectations of patients, rheumatologists,

and physiotherapists.

Munneke M, De Jong Z, Zwinderman AH, Ronday HK, Van Den Ende CH, Vliet

Vlieland TP, Hazes JM.

Leiden University Medical Centre, St Radboud, Department of

Physiotherapy (326), PO Box 9101, 6500 HB Nijmegen, The Netherlands.

m.munneke@...

OBJECTIVE: To examine the outcome expectations of RA patients,

rheumatologists, and physiotherapists regarding high intensity exercise

programmes compared with conventional exercise programmes. METHODS: An

exercise outcome expectations questionnaire was administered to 807 RA

patients, 153 rheumatologists, and 624 physiotherapists. The

questionnaire consisted of four statements regarding positive and

negative outcomes of high intensity exercise programmes and four similar

statements for conventional exercise programmes. A total expectation

score for both conventional and high intensity exercise was calculated,

ranging from -2 (very negative expectation) to 2 (very positive

expectation). RESULTS: The questionnaire was returned by 662 RA patients

(82%), 132 rheumatologists (86%), and 467 physiotherapists (75%). The

mean (95% confidence interval) scores for high intensity exercise

programmes were 0.30 (0.25 to 0.34), 0.68 (0.62 to 0.74), and -0.06

(-0.15 to 0.02), and for conventional exercise programmes were 0.99

(0.96 to 1.02), 1.13 (1.09 to 1.17), and 1.27 (1.21 to 1.34) for RA

patients, rheumatologists, and physiotherapists, respectively. In all

three respondent groups, the outcome expectations of high intensity

exercise were significantly less positive than those of conventional

exercise programme.

CONCLUSIONS: Despite the existing evidence regarding the effectiveness

and safety of high intensity exercise programmes, RA patients,

rheumatologists, and physiotherapists have more positive expectations of

conventional exercise programmes than of high intensity exercise

programmes. Physiotherapists were the least positive about outcomes of

high intensity exercise programmes while rheumatologists were the most

positive. To help the implementation of new insights in the

effectiveness of physical therapy modalities in rheumatology, the need

for continuous education of patients, rheumatologists and

physiotherapists is emphasised.

PMID: 15194575

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