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Assessment of a sixteen-week training program on strength, pain, and function in rheumatoid arthritis patients.
J Clin Rheumatol. 2009 Jun; 15(4):165-71.JC

Abstract

OBJECTIVE

To assess the effects of a 16-week progressive, individualized, high-intensity strength training program on muscle strength, pain, and function in patients with rheumatoid arthritis (RA).

METHODS

Twenty-four RA patients (men, n = 5; women, n = 19) receiving infliximab participated in a randomized controlled trial. The strength training (ST) group (n = 16) participated in a supervised program 3 times per week, and the control (C) group (n = 8) continued with standard of care as overseen by their rheumatologist. Assessments were completed at baseline and at weeks 8 and 16. Strength was measured by 3 repetition maximum (3RM), isometric hand dynamometer, and isokinetic dynamometer. A 100-mm visual analogue scale was used to assess pain. Functional performance was derived from a timed 50-foot walk and the Health Assessment Questionnaire Disability Index.

RESULTS

The mean percent increase in strength (3RM) for the ST group from baseline to week 16 was 46.1% +/- 31.6% (P < 0.01) (mean of all three 3RM exercises: hammer curl, leg press, and incline dumbbell press), with mean gains in strength up to 4 times that of baseline values reported in all strength training exercises (upper and lower body) performed during exercise sessions. On average, right-hand grip strength increased by 2.9 +/- 4.0 kg in the ST group, in comparison with a loss of 1.2 +/- 3.0 kg in the C group over 16 weeks. The ST group had a 53% reduction in pain, in comparison with almost no change in the C group. The ST group had a significant improvement in 50-foot walk time, with a mean reduction of -1.2 +/- 1.6 seconds, in comparison with the C group (mean increase of 0.8 +/- 1.0 seconds; P = 0.01) over the 16 weeks. There was a clinically important difference (predefined as mean change +/-0.25) in the Health Assessment Questionnaire Disability Index in the ST group (-0.4 +/- 0.4) but not in the C group (-0.1 +/- 0.4).

CONCLUSION

High-intensity strength training in RA patients with varying levels of disease activity and joint damage had a large, significant effect on strength, and led to improvements in pain and function, with additive patient benefits beyond the effect of their infliximab use.

Authors+Show Affiliations

Department of Kinesiology, Boise State University, Boise, Idaho, USA. hilaryflint-wagner@boisestate.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19279507

Citation

Flint-Wagner, Hilary G., et al. "Assessment of a Sixteen-week Training Program On Strength, Pain, and Function in Rheumatoid Arthritis Patients." Journal of Clinical Rheumatology : Practical Reports On Rheumatic & Musculoskeletal Diseases, vol. 15, no. 4, 2009, pp. 165-71.
Flint-Wagner HG, Lisse J, Lohman TG, et al. Assessment of a sixteen-week training program on strength, pain, and function in rheumatoid arthritis patients. J Clin Rheumatol. 2009;15(4):165-71.
Flint-Wagner, H. G., Lisse, J., Lohman, T. G., Going, S. B., Guido, T., Cussler, E., Gates, D., & Yocum, D. E. (2009). Assessment of a sixteen-week training program on strength, pain, and function in rheumatoid arthritis patients. Journal of Clinical Rheumatology : Practical Reports On Rheumatic & Musculoskeletal Diseases, 15(4), 165-71. https://doi.org/10.1097/RHU.0b013e318190f95f
Flint-Wagner HG, et al. Assessment of a Sixteen-week Training Program On Strength, Pain, and Function in Rheumatoid Arthritis Patients. J Clin Rheumatol. 2009;15(4):165-71. PubMed PMID: 19279507.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of a sixteen-week training program on strength, pain, and function in rheumatoid arthritis patients. AU - Flint-Wagner,Hilary G, AU - Lisse,Jeffrey, AU - Lohman,Timothy G, AU - Going,Scott B, AU - Guido,Terri, AU - Cussler,Ellen, AU - Gates,Donald, AU - Yocum,David E, PY - 2009/3/13/entrez PY - 2009/3/13/pubmed PY - 2009/9/25/medline SP - 165 EP - 71 JF - Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases JO - J Clin Rheumatol VL - 15 IS - 4 N2 - OBJECTIVE: To assess the effects of a 16-week progressive, individualized, high-intensity strength training program on muscle strength, pain, and function in patients with rheumatoid arthritis (RA). METHODS: Twenty-four RA patients (men, n = 5; women, n = 19) receiving infliximab participated in a randomized controlled trial. The strength training (ST) group (n = 16) participated in a supervised program 3 times per week, and the control (C) group (n = 8) continued with standard of care as overseen by their rheumatologist. Assessments were completed at baseline and at weeks 8 and 16. Strength was measured by 3 repetition maximum (3RM), isometric hand dynamometer, and isokinetic dynamometer. A 100-mm visual analogue scale was used to assess pain. Functional performance was derived from a timed 50-foot walk and the Health Assessment Questionnaire Disability Index. RESULTS: The mean percent increase in strength (3RM) for the ST group from baseline to week 16 was 46.1% +/- 31.6% (P < 0.01) (mean of all three 3RM exercises: hammer curl, leg press, and incline dumbbell press), with mean gains in strength up to 4 times that of baseline values reported in all strength training exercises (upper and lower body) performed during exercise sessions. On average, right-hand grip strength increased by 2.9 +/- 4.0 kg in the ST group, in comparison with a loss of 1.2 +/- 3.0 kg in the C group over 16 weeks. The ST group had a 53% reduction in pain, in comparison with almost no change in the C group. The ST group had a significant improvement in 50-foot walk time, with a mean reduction of -1.2 +/- 1.6 seconds, in comparison with the C group (mean increase of 0.8 +/- 1.0 seconds; P = 0.01) over the 16 weeks. There was a clinically important difference (predefined as mean change +/-0.25) in the Health Assessment Questionnaire Disability Index in the ST group (-0.4 +/- 0.4) but not in the C group (-0.1 +/- 0.4). CONCLUSION: High-intensity strength training in RA patients with varying levels of disease activity and joint damage had a large, significant effect on strength, and led to improvements in pain and function, with additive patient benefits beyond the effect of their infliximab use. SN - 1536-7355 UR - https://www.unboundmedicine.com/medline/citation/19279507/Assessment_of_a_sixteen_week_training_program_on_strength_pain_and_function_in_rheumatoid_arthritis_patients_ L2 - https://doi.org/10.1097/RHU.0b013e318190f95f DB - PRIME DP - Unbound Medicine ER -