Sustained maintenance of exercise induced muscle strength gains and normal BMD in patients with early RA

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Ann Rheum Dis. 2004 Aug;63(8):910-6.

Sustained maintenance of exercise induced muscle strength gains and

normal bone mineral density in patients with early rheumatoid arthritis:

a 5 year follow up.

Hakkinen A, Sokka T, Kautiainen H, Kotaniemi A, Hannonen P.

Department of Physical Medicine and Rehabilitation, Jyvaskyla Central

Hospital, Keskussairaalantie 19, FIN-40620 Jyvaskyla, Finland.

arja.hakkinen@...

OBJECTIVE: To investigate at 5 years whether an initial 2 year home

based strength training period imposes sustained effects on muscle

strength, bone mineral density (BMD), structural joint damage, and on

disease activity in patients with early rheumatoid arthritis (RA).

METHODS: Seventy patients were randomised either to perform home based

strength training with loads of 50-70% of repetition maximum (EG) or

range of motion exercises (CG). Both groups were encouraged to take part

in aerobic activities 2-3 times a week. Maximal muscle strength of

different muscle groups was measured by dynamometers, and BMD at the

femoral neck and lumbar spine by dual x ray densitometry. Disease

activity was assessed by the 28 joint disease activity score, and joint

damage by x ray findings. RESULTS: 62 patients completed 2 years'

training and 59 patients attended check up at 5 years. Mean (SD) maximum

muscle strength indices increased from baseline to 2 years-in EG from

212 (78) kg by a mean (95% CI) of 68 (55 to 80) and in CG from 195 (72)

kg by 35 (13 to 60) kg-and remained at that level for the next 3 years.

Development of BMD in EG tended to be more favourable than that in CG.

Muscle strength training was not detrimental to joint structures or

disease activity.

CONCLUSION: The patients' exercise induced muscle strength gains during

a 2 year training period were maintained throughout a subsequent self

monitored training period of 3 years. Despite substantial training

effects in muscle strength, BMD values remained relatively constant.

Radiographic damage remained low even at 5 years.

PMID: 15249317

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