title: Effects of a group-based exercise and educational program on physical performance and disease self-management in rheumatoid arthritis: a randomized controlled study.
abstract: BACKGROUND
  Evidence supports the use of educational and physical training programs for people with rheumatoid arthritis (RA).
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the effects of a group-based exercise and educational program on the physical performance and disease self-management of people with RA.
  
  
  METHODS
  This was a randomized controlled trial.
  
  
  METHODS
  The study was conducted at a rehabilitation center in the Netherlands.
  
  
  METHODS
  Thirty-four people diagnosed with RA participated in the study. Participants were randomly assigned to either an intervention group (n=19) or a waiting list control group (n=15).
  
  
  METHODS
  The intervention in this study was an 8-week, multidisciplinary, group therapy program for people with RA, consisting of physical exercise designed to increase aerobic capacity and muscle strength (force-generating capacity) together with an educational program to improve health status and self-efficacy for disease-self-management.
  
  
  METHODS
  The main outcome measures were maximum oxygen uptake (Vo(2)max), muscle strength of the elbow and knee flexors and extensors, health status, and perceived self-efficacy. All data were recorded before intervention in week 1, after intervention in week 9, and at follow-up in week 22.
  
  
  RESULTS
  The intervention group showed significant improvement (12.1%) in Vo(2)max at week 9 compared with the control group (-1.7%). Although significant within-group changes were found over time for muscle strength of the upper and lower extremities and health status that favored the intervention group, no between-group changes were found regarding these outcomes.
  
  
  CONCLUSIONS
  An important limitation was the small number of participants included in our study, which may have resulted in a lack of power.
  
  
  CONCLUSIONS
  The present group-based exercise and educational program for people with RA had a beneficial effect on aerobic capacity but not on muscle strength, health status, or self-efficacy.
authors.affiliation: Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, the Netherlands. g.breedland@cvr.umcg.nl
authors.forename: Ineke
authors.initials: I
authors.lastname: Breedland
authors.forename: Corinne
authors.initials: C
authors.lastname: van Scheppingen
authors.forename: Martha
authors.initials: M
authors.lastname: Leijsma
authors.forename: Nienke P
authors.initials: NP
authors.lastname: Verheij-Jansen
authors.forename: Ellen
authors.initials: E
authors.lastname: van Weert
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D010101:Oxygen Consumption; D010353:Patient Education as Topic; D012648:Self Care; D020377:Self Efficacy; D034941:Upper Extremity / Q000503:physiopathology; D055815:Young Adult