title: Effects of prolonged combined strength and endurance training on physical fitness, body composition and serum hormones in women with rheumatoid arthritis and in healthy controls.
abstract: OBJECTIVE
  The effects of a 21-week combined strength and endurance training period on physical fitness, serum hormone concentrations, and subcutaneous fat in 23 women with rheumatoid arthritis (RA) and in 12 matched healthy subjects was studied.
  
  
  METHODS
  The measurements included leg extension forces and EMG activity, muscle and fat thickness on thigh, maximal oxygen uptake (VO2max) and serum concentrations of testosterone, free testosterone, growth hormone, insulin-like growth factor-I (IGF-I), dehydroepiandrosterone sulphate (DHEAS), and cortisol.
  
  
  RESULTS
  During the training period significant increases took place in VO2max, muscle strength and EMG activity in both groups. The increases of the quadriceps femoris thickness were 6.5% (p < 0.001) in the healthy controls and 7.4% (p < 0.001) in the RA cases. The decreases in subcutaneous fat thicknesses were 9.9% (p < 0.001) and 12.3% (p < 0.001), respectively. No significant changes were found in serum hormone concentrations, but RA women showed lower levels of IGF-I during the whole follow-up.
  
  
  CONCLUSIONS
  In RA women with stable disease the combined strength and endurance training increases physical fitness. Further the training increases muscle mass and decreases subcutaneous fat. It may decrease risks of cardiovascular diseases in RA patients. The intensive training had minor effects on serum hormone concentrations.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, Jyväskylä, Finland. arja.hakkinen@ksshp.fi
authors.forename: A
authors.initials: A
authors.lastname: Häkkinen
authors.forename: A
authors.initials: A
authors.lastname: Pakarinen
authors.forename: P
authors.initials: P
authors.lastname: Hannonen
authors.forename: H
authors.initials: H
authors.lastname: Kautiainen
authors.forename: K
authors.initials: K
authors.lastname: Nyman
authors.forename: W J
authors.initials: WJ
authors.lastname: Kraemer
authors.forename: K
authors.initials: K
authors.lastname: Häkkinen
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D001823:Body Composition; D004576:Electromyography; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006304:Health Status; D006728:Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000473:pathology / Q000502:physiology; D010101:Oxygen Consumption / Q000502:physiology; D010807:Physical Endurance; D010809:Physical Fitness / Q000502:physiology*; D012720:Severity of Illness Index; D014463:Ultrasonography
chemical_list: D006728:Hormones