Bone Abstracts

Introduction: The patients with rheumatoid arthritis (RA) are less physically active than the general population. The aim of the study is to assess the effect of two exercise programs on the functional status of patients with early RA.

Methods: Fifteen patients with early RA underwent ten high-intensity dynamic exercises using Enraf-Nonius gym for 45–60 min, including aerobic part (En-Cardio) and 18–20 muscle-strengthening exercises (En-Dynamic Track), 18 patients – 10 therapeutic exercises for 45 min under the supervision of a trainer. The 45-min exercises lasted three times a week for 3 months. 18 patients received only drug therapy (control). HAQ, RAPID3, the average powers of knee extension and ankle flexion by the EN-TreeM movement analysis were evaluated.

Results: Efficacy of the gym exercises was higher than the therapeutic exercises by HAQ and RAPID3 (P<0.05). In the gym group HAQ decreased by 60.7% (0.82±0.43, P<0.01), RAPID3 – by 47.5% (4.67±0.65, P<0.01). The average extension power of a weaker knee increased by 87.9%, of a stronger – by 70.5% (P<0.01). The average flexion power of a more affected ankle joint elevated by 84.6%, of a less affected – by 68.8% (P<0.01). Adherence to the therapeutic exercises for 3 months was better (83.3%) then to the gym exercises (60.0%). Predictors of the regular gym exercises were the young age and the very early stage of RA. The patients of the both groups, who regularly did exercises, had pronounced clinical improvement by HAQ and good response to treatment by RAPID3 more frequently (P<0.01). After 3 months there was statistically significant differences between the both exercise groups and the control group in most parameters (P<0.05).

Conclusion: The gym high-intensity dynamic exercises and the therapeutic exercises improve functional status and increase power of motion in patients with early RA.