Effect of a high-intensity weight-bearing exercise program on radiologic damage progression of the large joints in subgroups of patients with rheumatoid arthritis
Article first published online: 2 JUN 2005
Copyright © 2005 by the American College of Rheumatology
Arthritis Care & Research
Volume 53, Issue 3, pages 410–417, 15 June 2005
How to Cite
Munneke, M., de Jong, Z., Zwinderman, A. H., Ronday, H. K., van Schaardenburg, D., Dijkmans, B. A. C., Kroon, H. M., Vliet Vlieland, T. P. M. and Hazes, J. M. W. (2005), Effect of a high-intensity weight-bearing exercise program on radiologic damage progression of the large joints in subgroups of patients with rheumatoid arthritis. Arthritis & Rheumatism, 53: 410–417. doi: 10.1002/art.21165
- Issue published online: 2 JUN 2005
- Article first published online: 2 JUN 2005
- Manuscript Accepted: 24 NOV 2004
- Manuscript Received: 21 APR 2004
- Dutch Health Care Insurance Board. Grant Number: OG-97-024
- Rheumatoid arthritis;
- Joint damage progression;
- Randomized controlled trials
To investigate whether a high-intensity exercise program accelerates the rate of radiologic damage of the large joints in predefined subgroups of patients with rheumatoid arthritis.
The data of 277 participants in a 2-year randomized controlled trial, comparing the effects of high-intensity exercises with usual care, were used. Linear regression analysis was used to test which predefined variables at baseline (age, disease duration, disease activity, physical capacity, functional ability, joint damage) modified the effect of high-intensity exercise on the progression of radiologic damage of the large joints over 24 months.
Baseline radiologic joint damage was the only variable associated with the effect of high-intensity exercise on joint damage progression in large joints. In a subgroup of 218 patients with no or little joint damage (defined as Larsen score ≤5; 80% of our study population) the proportions of patients with an increase in joint damage were similar for the exercise and usual-care group (35% versus 36%, risk ratio [RR] 1.0 [0.7–1.4]; P = not significant), whereas, in a subgroup of 59 patients who already had extensive damage of large joints (defined as Larsen score >5) the proportion was significantly higher in the exercise group (85% versus 48%, RR 1.8 [1.2–2.6]; P < 0.05).
High-intensity weight-bearing exercises appear to accelerate joint damage progression in patients with preexisting extensive damage. Patients with extensive large joint damage should, therefore, be advised to refrain from activities excessively loading the damaged joints.