The British Journal of Rheumatology, Vol 37, 677-687, Copyright © 1998 by British Society for Rheumatology
CH Van den Ende, TP Vliet Vlieland, M Munneke and JM Hazes
The aim of this systematic review was to determine the effectiveness of
dynamic exercise therapy in improving joint mobility, muscle strength,
aerobic capacity and daily functioning in patients with rheumatoid
arthritis (RA). In addition, possible unwanted effects such as an increase
in pain, disease activity and radiological progression were studied. A
computer-aided search of the MEDLINE, Embase and SCISEARCH databases was
performed to identify controlled trials on the effect of exercise therapy.
Randomized trials were selected on the effect of dynamic exercise therapy
in RA patients with an exercise programme fulfilling the following
criteria: (a) intensity level such that heart rates exceeded 60% of maximal
heart rate during at least 20 min; (b) exercise frequency > or = 2 a
week; and (c) duration of intervention > or = 6 weeks. Two blinded
reviewers independently selected eligible studies, rated the methodological
quality and extracted data. Six out of 30 identified controlled trials met
the inclusion criteria. Four of the six included studies fulfilled > or
= 7/10 methodological criteria. Because of heterogeneity in outcome
measures, data could not be pooled. The results suggest that dynamic
exercise therapy is effective in increasing aerobic capacity and muscle
strength. No detrimental effects on disease activity and pain were
observed. The effects of dynamic exercise therapy on functional ability and
radiological progression are unclear. It is concluded that dynamic exercise
therapy has a positive effect on physical capacity. Research on the
long-term effect of dynamic exercise therapy on radiological progression
and functional ability is needed.
REVIEWS
Dynamic exercise therapy in rheumatoid arthritis: a systematic review
Department of Rheumatology, Leiden University Medical Center, The Netherlands.
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