Effects of dynamic strength training on physical function, Valpar 9 work sample test, and working capacity in patients with recent‐onset rheumatoid arthritis

Abstract

Objective. To study the impact of 24 months of strength training on the physical function of patients with early rheumatoid arthritis (RA). Methods. Seventy patients were assigned to either the strength training (experimental) group (n ‫؍‬ 35) or the control group (n ‫؍‬ 35). Patients in the experimental group performed strength training for 24 months, and control patients were instructed to perform range of motion exercises. Maximal strength of the knee extensors, trunk flexors, and extensors, as well as grip strength were recorded with dynamometers. Disease activity was assessed by the erythrocyte sedimentation rate and Ritchie's articular index, joint damage was determined by the Larsen x-ray index, and functional capacity was assessed using the Valpar 9 test and the Stanford Health Assessment Questionnaire (HAQ). The employment status of each patient was recorded. Results. In the experimental group, strength training led to significant increases (19 -59%) in maximal strength of the trained muscles. Such increases in the control group varied from 1% to 31%. There was a clear training effect on muscular strength in favor of the experimental group, but significant improvements in the HAQ indices as well as in the Valpar 9 test were seen also in control patients. Results of the Valpar 9 and the HAQ were statistically significantly better in patients who remained gainfully employed compared with patients who retired preterm during followup. However, compared with patients who remained in the work force, patients who retired were older, and their work was physically more demanding. Conclusion. As expected, strength training led to increased muscle strength, but this increase did not correlate with improved physical function as assessed by the Valpar 9 work sample test. The increased muscle performance did not prevent a substantial proportion of patients from retiring preterm. The 2 items from the Valpar 9 test that were applied were not sensitive enough to differentiate the patients according to their working status.

Physical Activity to Reduce Fatigue in Rheumatoid Arthritis: A Randomized Controlled Trial

“…We also found, similar to other published studies, that many individuals with RA have very low levels of physical activity (10,11) in spite of the demonstrated safety of exercise and published guidelines recommending physical activity for persons with RA (12). Although studies have examined the impact of exercise interventions on RA outcomes, most have focused on pain or function (13)(14)(15)(16)(17). Two recent systematic reviews found that physical activity did have beneficial effects on fatigue (18,19), but most exercise interventions have been resource intensive, requiring specially trained personnel, highly structured activities, and/or attendance at classes or a specified facility.…”

Activity limitation in rheumatoid arthritis correlates with reduced grip force regardless of sex: The Swedish TIRA project

“…Several studies have reported that grip force increases as a result of interventions (30,(37)(38)(39)(40)(41)(42). The results in the present study also indicate that increasing the grip force may result in reduced activity limitations.…”

A systematic review of the effects of dynamic exercise in rheumatoid arthritis

“…11 Improvements in aerobic capacity were reported by a number of the aerobic and combined exercise programmes 12-14, 20, 25 , but not by the pure strength training programmes. [16][17][18][19]25 Conversely the strength training programmes report significant increases in muscle strength but not in aerobic capacity.…”

“…The studies by Hakkinen et al 15,16,17,18,19 years. 23 The intervention was concentric quadriceps and hamstring training.…”

“…[15][16][17][18][19] Significant differences between the exercise and control groups were seen for ESR (- 23 She also reports significant improvements in knee flexor and extensor torque in the exercise group compared with the controls.…”