title: Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results of a randomised clinical trial.
abstract: OBJECTIVE
  To investigate the benefit of intensive dynamic exercises in comparison to range of motion (ROM) and isometric exercises in rheumatoid arthritis.
  
  
  METHODS
  100 consecutive rheumatoid arthritis patients on stable medication were randomly assigned to (1) intensive dynamic group exercises which included full weight bearing exercises and conditioning exercises on a stationary bicycle while the heart rate was maintained at 70-85% of the age predicted maximum heart rate, (2) range of motion (ROM) exercises and isometric exercises in a group, (3) individual isometric and ROM exercises, and (4) home instructions for isometric and ROM exercises. Variables of physical condition, muscle strength, joint mobility, daily functioning (HAQ), and disease activity were assessed before and after the 12 week exercise course, and 12 weeks thereafter. An intention to treat analysis was performed.
  
  
  RESULTS
  Increases in aerobic capacity (n = 77), muscle strength, and joint mobility in the high intensity exercise programme were respectively 17%, 17% and 16% and differed significantly from the changes in aerobic capacity, muscle strength, and joint mobility in the other exercise groups. No deterioration of disease activity was observed. Twelve weeks after discontinuation of the exercise course the gain in physical capacity had disappeared.
  
  
  CONCLUSIONS
  Intensive dynamic training is more effective in increasing aerobic capacity, joint mobility, and muscle strength than ROM exercises and isometric training in rheumatoid arthritis patients with well controlled disease.
authors.affiliation: University Hospital Leiden, The Netherlands, Department of Rheumatology.
authors.forename: C H
authors.initials: CH
authors.lastname: van den Ende
authors.forename: J M
authors.initials: JM
authors.lastname: Hazes
authors.forename: S
authors.initials: S
authors.lastname: le Cessie
authors.forename: W J
authors.initials: WJ
authors.lastname: Mulder
authors.forename: D G
authors.initials: DG
authors.lastname: Belfor
authors.forename: F C
authors.initials: FC
authors.lastname: Breedveld
authors.forename: B A
authors.initials: BA
authors.lastname: Dijkmans
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000628:therapy*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000503:physiopathology; D010349:Patient Compliance; D012720:Severity of Illness Index; D014797:Vital Capacity