RESEARCH - A dynamic exercise program to improve patients' disability in RA: a prospective randomized controlled trial

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Rheumatology (Oxford). 2009 Apr;48(4):410-5. Epub 2009 Feb 11.

A dynamic exercise programme to improve patients' disability in

rheumatoid arthritis: a prospective randomized controlled trial.

Baillet A, Payraud E, Niderprim VA, Nissen MJ, et B, François P,

Grange L, Casez P, Juvin R, Gaudin P.

1Clinic of Rheumatology, Hôpital Sud, Echirolles, Hôpital A Michallon,

Grenoble, France.

OBJECTIVE: To evaluate the functional, clinical, radiological and

quality of life outcomes of a 4-week dynamic exercise programme (DEP)

in RA.

METHODS: Patients matched on the principal medico-social parameters

were randomly assigned to either the DEP or the conventional joint

rehabilitation group. Primary end point for judging effectiveness was

functional status assessed by HAQ. Secondary outcomes included

Nottingham Health Profile (NHP), Arthritis Impact Measurement Scale

2-Short Form (AIMS2-SF) and radiological worsening measured by Simple

Narrowing Erosion Score (SENS). Clinical evaluation consisted of

disease activity score (DAS 28), cycling aerobic fitness and

dexterity. Dexterity was measured using Sequential Occupational

Dexterity Assessment (SODA) and Duruoz Hand Index (DHI). Data were

collected at baseline 1, 6 and 12 months.

RESULTS: Fifty patients were enrolled. HAQ improved throughout the

length of the trial in the DEP group. This improvement was greater in

DEP than in the standard joint rehabilitation group at 1 month (-0.2

vs no variation from baseline, P = 0.04), but not at 6 months (-0.2 vs

-0.1 in control group, P = 0.25) or 12 months (-0.1 vs no variation in

control group, P = 0.51). DEP improved NHP (-23 vs + 7% in control

group, P = 0.01) and aerobic fitness (+0.3 vs + 0.1 km per 5 min in

control group, P = 0.02) at 1 month but the progress was not

statistically significant thereafter. DEP also improved DHI, SODA, DAS

28 and AIMS2-SF, although not significantly.

CONCLUSION: DEP was effective on functional status assessed by HAQ,

quality of life and aerobic fitness at 1 month.

PMID: 19211654

http://www.ncbi.nlm.nih.gov/pubmed/19211654

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