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Slowing of bone loss in patients with rheumatoid arthritis by long-term high-intensity exercise: results of a randomized, controlled trial.
Arthritis Rheum. 2004 Apr; 50(4):1066-76.AR

Abstract

OBJECTIVE

Patients with rheumatoid arthritis (RA) are more at risk for the development of osteoporosis and osteoporotic fractures than are their healthy peers. In this randomized, controlled, multicenter trial, the effectiveness of a 2-year high-intensity weight-bearing exercise program (the Rheumatoid-Arthritis-Patients-In-Training [RAPIT] program) on bone mineral density (BMD) was compared with usual care physical therapy, and the exercise modalities associated with changes in BMD were determined.

METHODS

Three hundred nine patients with RA were assigned to an intervention group, either the RAPIT program or usual care physical therapy. The primary end points were BMD of the hip and spine. The exercise modalities examined were aerobic fitness, muscle strength, and, as a surrogate for those effects not directly measured by the RAPIT program, attendance rate.

RESULTS

The data on the 136 RAPIT participants and 145 usual care participants who completed the study were analyzed. The mean rate of decrease in hip BMD, but not in lumbar spine BMD, was smaller in patients participating in the RAPIT program when compared with that in the usual care group, with a mean decrease of 1.6% (95% confidence interval [95% CI] 0.8-2.5) over the first year and 0.5% (95% CI 1.1-2.0) over the second year. The change in hip BMD was significantly and independently associated with changes in both muscle strength (multivariate odds ratio [OR] 1.75, 95% CI 1.07-2.86) and aerobic fitness (OR 1.79, 95% CI 1.10-2.90), but not with the attendance rate (OR 1.00, 95% CI 0.99-1.00).

CONCLUSION

A long-term high-intensity weight-bearing exercise program for RA patients is effective in slowing down the loss of BMD at the hip. The exercise modalities associated with this effect are muscle strength and aerobic fitness.

Authors+Show Affiliations

Leiden University Medical Center, Leiden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15077288

Citation

de Jong, Zuzana, et al. "Slowing of Bone Loss in Patients With Rheumatoid Arthritis By Long-term High-intensity Exercise: Results of a Randomized, Controlled Trial." Arthritis and Rheumatism, vol. 50, no. 4, 2004, pp. 1066-76.
de Jong Z, Munneke M, Lems WF, et al. Slowing of bone loss in patients with rheumatoid arthritis by long-term high-intensity exercise: results of a randomized, controlled trial. Arthritis Rheum. 2004;50(4):1066-76.
de Jong, Z., Munneke, M., Lems, W. F., Zwinderman, A. H., Kroon, H. M., Pauwels, E. K., Jansen, A., Ronday, K. H., Dijkmans, B. A., Breedveld, F. C., Vliet Vlieland, T. P., & Hazes, J. M. (2004). Slowing of bone loss in patients with rheumatoid arthritis by long-term high-intensity exercise: results of a randomized, controlled trial. Arthritis and Rheumatism, 50(4), 1066-76.
de Jong Z, et al. Slowing of Bone Loss in Patients With Rheumatoid Arthritis By Long-term High-intensity Exercise: Results of a Randomized, Controlled Trial. Arthritis Rheum. 2004;50(4):1066-76. PubMed PMID: 15077288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Slowing of bone loss in patients with rheumatoid arthritis by long-term high-intensity exercise: results of a randomized, controlled trial. AU - de Jong,Zuzana, AU - Munneke,Marten, AU - Lems,Willem F, AU - Zwinderman,Aeilko H, AU - Kroon,Herman M, AU - Pauwels,Ernest K J, AU - Jansen,Annemarie, AU - Ronday,Karel H, AU - Dijkmans,Ben A C, AU - Breedveld,Ferdinand C, AU - Vliet Vlieland,Theodora P M, AU - Hazes,Johanna M W, PY - 2004/4/13/pubmed PY - 2004/5/12/medline PY - 2004/4/13/entrez SP - 1066 EP - 76 JF - Arthritis and rheumatism JO - Arthritis Rheum VL - 50 IS - 4 N2 - OBJECTIVE: Patients with rheumatoid arthritis (RA) are more at risk for the development of osteoporosis and osteoporotic fractures than are their healthy peers. In this randomized, controlled, multicenter trial, the effectiveness of a 2-year high-intensity weight-bearing exercise program (the Rheumatoid-Arthritis-Patients-In-Training [RAPIT] program) on bone mineral density (BMD) was compared with usual care physical therapy, and the exercise modalities associated with changes in BMD were determined. METHODS: Three hundred nine patients with RA were assigned to an intervention group, either the RAPIT program or usual care physical therapy. The primary end points were BMD of the hip and spine. The exercise modalities examined were aerobic fitness, muscle strength, and, as a surrogate for those effects not directly measured by the RAPIT program, attendance rate. RESULTS: The data on the 136 RAPIT participants and 145 usual care participants who completed the study were analyzed. The mean rate of decrease in hip BMD, but not in lumbar spine BMD, was smaller in patients participating in the RAPIT program when compared with that in the usual care group, with a mean decrease of 1.6% (95% confidence interval [95% CI] 0.8-2.5) over the first year and 0.5% (95% CI 1.1-2.0) over the second year. The change in hip BMD was significantly and independently associated with changes in both muscle strength (multivariate odds ratio [OR] 1.75, 95% CI 1.07-2.86) and aerobic fitness (OR 1.79, 95% CI 1.10-2.90), but not with the attendance rate (OR 1.00, 95% CI 0.99-1.00). CONCLUSION: A long-term high-intensity weight-bearing exercise program for RA patients is effective in slowing down the loss of BMD at the hip. The exercise modalities associated with this effect are muscle strength and aerobic fitness. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/15077288/Slowing_of_bone_loss_in_patients_with_rheumatoid_arthritis_by_long_term_high_intensity_exercise:_results_of_a_randomized_controlled_trial_ L2 - https://doi.org/10.1002/art.20117 DB - PRIME DP - Unbound Medicine ER -