The effect of isometric exercise of the hand on the synovial blood flow in patients with rheumatoid arthritis measured by color Doppler ultrasound.
In 90% of patients with rheumatoid arthritis (RA), the joints of the hand are affected. Studies of grip strength training have not indicated a negative effect on disease activity after training. Introduction of ultrasound Doppler (USD) to measure increased blood flow induced by inflammation has made it possible to investigate the direct effect on blood supply in the synovium after training. In this case-control study, 24 patients with RA with USD activity in the wrist joint participated. The USD activity was measured by the color fraction (CF) (CF = colored pixels/total number of pixels in ROI). Twenty-four patients were assigned to an 8-week grip strength training program. At baseline and after 8 weeks of training, an USD examination of the wrist joint was performed. In the training group, we measured grip strength and pain in the wrist joint. Six patients withdrew from the training because of pain or change in medication. Eighteen patients served as control group. There was a modest, not significant, decrease in the CF in response to training (1.86%; P = 0.08). Grip strength increased 8.8% after training (P = 0.055). Pain in motion deceased after training (P = 0.04). No difference in the CF was seen between the training and control groups, neither at baseline nor at follow-up (P = 0.82 and P = 0.48). Patients withdrawing from training had a significantly higher CF than the other patients (P > 0.001). The results in this study might indicate that the flow in the synovium assessed by USD is not affected by grip strength training.
The Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark. parker@frh.regionh.dk
Karen
K
Ellegaard
Søren
S
Torp-Pedersen
Hans
H
Lund
Kirsten
K
Pedersen
Marius
M
Henriksen
Bente
B
Danneskiold-Samsøe
Henning
H
Bliddal
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000628:therapy*; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D010045:Outpatients; D013583:Synovial Membrane / Q000098:blood supply* / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014955:Wrist Joint / Q000098:blood supply / Q000000981:diagnostic imaging / Q000502:physiology*