NEWS - Arthritic joints stand up to intensive exercise

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Arthritic joints stand up to intensive exercise

Last Updated: 2004-11-03 12:30:56 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Long-term high-intensity exercise does not

accelerate the progression of joint damage in the hands and feet of

people with rheumatoid arthritis, according to a Dutch report.

Exercise known to benefit arthritis patients, increasing their physical

capacity, functional ability, and emotional, the researchers explain in

the ls of the Rheumatic Diseases. However, little is known about the

effects of exercise on damage to the small joints of the hands and feet.

Dr. Z. de Jong from Leiden University Medical Center and colleagues

studied a total of 309 patients with rheumatoid arthritis who were

divided randomly into a high-intensity exercise group or a regular

physical exercise. After two years, 136 participants in the

high-intensity and 145 in the control exercise group were still in the

trial.

At that point, the number of damaged joints in the hands and feet

increased in both groups and did not differ between them, the team

reports.

For those who did experience a rapid increase in damage to these joints,

three factors seemed to be key -- worse existing damage before the study

started, higher disease activity during the study, and decreases rather

than increases in aerobic fitness, the researchers note.

" This is the first time that improvement in aerobic fitness has been

shown to predict, independently of other factors, a decrease in the rate

of local bone damage, " they point out.

In conclusion, " We provide evidence that participation in a long-term

high-intensity weight-bearing exercise program comprising improvement in

aerobic fitness and impact-generating activities does not increase the

rate of radiological joint damage of the hands and feet in patients with

rheumatoid arthritis, " the team writes.

" On the contrary, it seems that these exercises have a protective effect

for the joints of the feet, " they say.

" I think the next step will be to see how safe these exercises are for

people with prostheses and/or extensive damage to the large

weight-bearing joints, " de Jong told Reuters Health. " Also, the

effectiveness of cheaper alternatives like (partly) home-based training

will be explored. "

His advice to doctors who care for patients with rheumatoid arthritis:

" Do not be afraid to advise your patients to exercises vigorously! Trust

that they are able to do it. "

SOURCE: ls of the Rheumatic Diseases, November 2004.

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Mayo Clinic in Rochester

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s Hopkins Medicine

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