Progressive resistance training (PRT) improves rheumatoid arthritis outcomes: A district general hospital (DGH) model

Morsley, Klara; Berntzen, Berna; Erwood, Lisa; Bellerby, T.; Williamson, Lyn

doi:10.1002/msc.1193

Cited by 14 publications

(31 citation statements)

References 20 publications

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“…Resistance training is known as a treatment for muscle mass increase and improves BC. Morsley et al . reported that BF% in 83 patients with RA and other inflammatory arthritis decreased by 1.78 ± 8.22% and HAQ‐DI decreased by 0.24 ± 0.62 (both P < 0.0001) after 6‐week progressive resistance training.…”

Section: Discussionmentioning

confidence: 99%

Myopenia is associated with joint damage in rheumatoid arthritis: a cross‐sectional study

Lin

Liang

et al. 2019

J cachexia sarcopenia muscle

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Background The link between body mass index (BMI) and disease characteristics in rheumatoid arthritis (RA) remains controversial. Body composition (BC) has been more frequently recommended to be used instead of BMI for more accurate assessment. Our study aimed to investigate the characteristics of BC in RA patients and their associations with disease characteristics. Methods Body composition was assessed in consecutive Chinese RA patients and control subjects by bioelectric impedance analysis. Overfat was defined by body fat percentage (BF%) as ≥25% for men and ≥35% for women. Myopenia was defined by appendicular skeletal muscle mass index (ASMI) ≤7.0 kg/m 2 in men and ≤5.7 kg/m 2 in women. BMI and clinical data including disease activity, function, and radiographic assessment were collected. Active disease was defined by disease activity score in 28 joints with four variables including C‐reactive protein (DAS28‐CRP) ≥2.6. Functional limitation was defined as Stanford health assessment questionnaire disability index (HAQ‐DI) >1. Radiographic joint damage (RJD) was defined as the Sharp/van der Heijde modified sharp score (mTSS) >10. Results There were 457 RA patients (mean age 49.5 ± 13.1 years old with 82.7% women) and 1860 control subjects (mean age 34.3 ± 9.9 years old with 51.2% women) recruited. Comparisons of BMI and BC between RA patients and control subjects in age and gender stratification showed that lower BMI with 17.7% underweight and lower ASMI with 45.1% myopenia are the main characteristics in RA patients. Compared with those without myopenia, RA patients with myopenia had significantly higher DAS28‐CRP (median 3.5 vs. 3.0), higher HAQ‐DI (median 0.38 vs. 0.13) with higher rate of functional limitation (24.8% vs. 7.6%), and higher mTSS (median 22.3 vs. 9.0) with more RJD (71.8% vs. 45.8%) (all P < 0.001). Multivariate logistic regression analysis showed myopenia were positively associated with functional limitation (OR = 2.546, 95% CI: 1.043–6.217) and RJD (OR = 2.660, 95% CI: 1.443–4.904). All RA patients were divided into four BC subgroups according to overfat and myopenia. Those with both overfat and myopenia had the worst disease characteristics. After adjustment for confounding factors, significant additive interactions were observed between overfat and myopenia in active disease (AP = 0.528, 95% CI: 0.086–0.971), functional limitation (AP = 0.647, 95% CI: 0.356–0.937), and RJD (AP = 0.514, 95% CI: 0.139–0.890). Conclusions Myopenia is very common in RA patients that is associated with functional limitation and joint damage in RA. Further research on the underlying mechanism and the effect of skeletal muscle mass improvement in RA management are worth exploring in the future.

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Section: Discussionmentioning

confidence: 99%

Myopenia is associated with joint damage in rheumatoid arthritis: a cross‐sectional study

Lin

Liang

et al. 2019

J cachexia sarcopenia muscle

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“…It could also be asserted that sexual activity through physical training leads to better physical performance. It has been shown that physical training has many positive effects in patients with RA [ 29 ]. This could also contribute to the explanation of why physical performance is associated with sexual health in RA patients.…”

Section: Discussionmentioning

confidence: 99%

“…There are several implications of the findings for clinical routine that should be stressed: first, we cannot prove that improving physical fitness in RA patients will also improve sexual function and sexual satisfaction. However, several studies have shown the beneficial effects of physical training in RA patients [ 29 , 37 ], and physical training should, therefore, be implemented in RA patients for many different reasons. In addition, the effect of physical training on chronic inflammation has been shown in several studies [ 38 , 39 ], and this could, in addition to many other benefits, also improve sexual function.…”

Section: Discussionmentioning

confidence: 99%

Sexual health in patients with rheumatoid arthritis and the association between physical fitness and sexual function: a cross-sectional study

et al. 2018

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The aim of this study was to examine sexual health in patients with rheumatoid arthritis (RA), and to analyse factors associated with sexual health with a focus on physical fitness. One hundred RA patients aged between 18 and 65 years were included in a cross-sectional study. Handgrip strength and knee extensor strength were measured with a dynamometer, and physical performance with the Short Physical Performance Battery (SPPB). Fifty-four patients, mean age 47.8 (SD 10.6) years, 61% female, answered a questionnaire about sexual health. Fifty-seven percent reported, at least, sometimes having difficulty with sexual intercourse (27.8% due to joint stiffness, 24.1% due to fatigue, 18.5% due to pain). Handgrip strength and knee extensor strength significantly correlated with the desire to engage in sexual intercourse, frequency of sexual contact and satisfaction with overall sex life. The SPPB total score correlated with satisfaction with overall sex life, and the SPPB repeated chair stands test with the desire to have sexual intercourse and satisfaction with overall sex life. After adjusting for age, gender, disease activity, comorbidity, co-medication and pain intensity, the repeated chair stands test remained significantly associated with the frequency of sexual contact (0.53; 0.01–1.05) and with satisfaction with overall sex life (1.39; 0.28–2.51). The results of this study show that problems with sexual health are highly prevalent in patients with RA. The ability to rise from a chair is associated with sexual function, independent of disease activity and pain intensity.

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“…Es liegen inzwischen mehrere Studien vor, die einen positiven Effekt von intensiven Krafttraining gerade bei Rheumapatienten unter DMARD-Therapie nachgewiesen haben [1,[13][14][15]. Interessant erscheinen hier insbesondere 2 Studien aus den Niederlanden über "High Intensity Training" mit intensivem Zirkel-Krafttraining zum Muskelaufbau im Vergleich zu einer Kontroll-Gruppe mit "normaler" Physiotherapie".…”

Section: Auswahl Der Sportart Und Studienlageunclassified

Sport und Rheuma

Illgner

2018

Akt Rheumatol

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ZusammenfassungEs werden ca. 200–300 verschiedene Krankheitsbilder dem „rheumatischen Formenkreis“ zugeordnet, und so heterogen wie diese Erkrankungen sind die Verläufe innerhalb dieser Erkrankungen beim einzelnen Patienten. In den letzten Jahren konnten enorme Fortschritte in Diagnostik und Pharmakotherapie insbesondere auch in der Versorgungsstrategie durch das „Treat to Target“ Prinzip erzielt werden. Obwohl eine breite Datenlage zu den positiven Effekten von Sport bei Rheumapatienten vorliegt, herrscht hier oft noch Unsicherheit über Art und Weise einer möglichen sportlichen Betätigung bei Ärzten und Patienten vor. Nicht nur für leichtes aerobes Ausdauertraining und „Low-instensity-Sport“ sondern auch für den Nutzen von intensivem Krafttraining liegen gute Daten vor. Durch den Einsatz moderner Hilfsmittel könnte die Sportfähigkeit vieler Patienten noch deutlich gesteigert werden. Noch wichtiger aber erscheint es, Unsicherheiten zu beseitigen, zu Sport zu motivieren, aber natürlich auch auf der anderen Seite, Risiken und Gefahren im Einzelfall im Vorfeld schon zu erkennen und zu umgehen.

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Progressive resistance training (PRT) improves rheumatoid arthritis outcomes: A district general hospital (DGH) model

Abstract: Patients with early and established inflammatory arthritis alike benefited from a 6-week PRT programme provided within a National Health Service setting. Although further work is needed to look at long-term effects, we suggest that this intervention should be more widely available.

Cited by 14 publications

References 20 publications

Myopenia is associated with joint damage in rheumatoid arthritis: a cross‐sectional study

Myopenia is associated with joint damage in rheumatoid arthritis: a cross‐sectional study

Sexual health in patients with rheumatoid arthritis and the association between physical fitness and sexual function: a cross-sectional study

Sport und Rheuma

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