REVIEW - Safety of exercise in patients with RA

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Safety of exercise in patients with rheumatoid arthritis.

Rehabilitation medicine in rheumatic diseases

Current Opinion in Rheumatology. 17(2):177-182, March 2005.

de Jong, Zuzana; Vliet Vlieland, Theodora P. M

Abstract:

Purpose of review: Patients with rheumatoid arthritis benefit from long-term

moderate or high-intensity exercises. Moderate or high-intensity exercises

were found to improve aerobic capacity, muscle strength, functional ability,

and psychological well-being, and slow the age-related and sex-related

decrease in bone mineral density of the hip. Despite these positive

findings, there is also concern about its risks. Studies on the effects of

exercise on disease activity and joint damage are reviewed.

Recent findings: Studies on the effects of moderate or high-intensity

exercise in rheumatoid arthritis demonstrate either decreased or stable

disease activity. From the few available studies that address exercise and

radiologic progression of the small joints, results indicate that exercises

are safe for the joints of hands and feet. However, a recent study suggests

caution in prescribing long-term high-intensity weight-bearing exercises to

patients who have significant radiologic damage of large joints, as some

patients might develop additional damage.

Summary: Moderate or high-intensity weight-bearing exercises are safe with

respect to disease activity and radiologic damage of the hands and feet. In

the absence of sufficient data on exercise and radiologic progression of the

large joints, patients with significant radiologic damage of the large

joints should not be encouraged to participate in moderate to high-intensity

weight-bearing exercise unless individualized to protect affected joints. A

broader dissemination of the effectiveness and safety of moderate and

high-intensity exercise for patients with rheumatoid arthritis is needed

among rheumatologists, physical therapists, and patients.

© 2005 Lippincott & Wilkins, Inc.

http://www.co-rheumatology.com/pt/re/corheum/abstract.00002281-200503000-00013.h\

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