A randomized controlled trial to evaluate the effectiveness of an exercise program in women with rheumatoid arthritis taking low dose prednisone.
OBJECTIVE
To evaluate the effects of a 12 month, weight bearing, aerobic exercise program on disease activity, physical function, and bone mineral density (BMD) in women with rheumatoid arthritis (RA) taking low dose prednisone.


METHODS
A group of women with RA (n = 23) not receiving steroid therapy and in American College of Rheumatology functional class I or II was compared to 30 steroid treated patients with similar demographics. The latter group was randomized to usual care (n = 16) or an aerobic, weight bearing exercise program (n = 14) 3 times a week for 12 months. All subjects were recruited from an outpatient rheumatology clinic or physical therapy department and met the study inclusion criteria. Outcome measures included disease activity (erythrocyte sedimentation rate, active joint count), physical function (Health Assessment Questionnaire disability index, activity level) and BMD of the spine and femoral neck (by dual energy projection radiology).


RESULTS
Subjects in the exercise group had a small but nonsignificant decrease in disease activity and statistically significant improvements in function (p = 0.05) and activity levels (p = 0.05). BMD remained unchanged in the exercise group, decreased significantly (p = 0.004) in the nonsteroid comparison group (hip), and changed nonsignificantly in the control group. However, between-group changes in spinal BMD of the steroid treated groups was not significant (p = 0.09).


CONCLUSIONS
Women with RA taking low dose steroid therapy can safely participate in a dynamic, weight bearing exercise program with positive effects on their physical function, activity and fitness levels, and BMD with no exacerbation of disease activity.
Physical Therapy Department, Vancouver Hospital and Health Sciences Centre, British, Columbia, Canada.
M D
MD
Westby
J P
JP
Wade
K K
KK
Rangno
J
J
Berkowitz
D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005081:Exercise Therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology
D011241:Prednisone