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Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis
Cochrane Reviews, 10/08/09

Van der Hurkmans E et al. – Based on the evidence, aerobic capacity training combined with muscle strength training is recommended as routine practice in patients with RA.

• A literature search (to December 2008) within various databases was performed in order to identify randomised controlled trials (RCTs).
• RCTs that included an exercise program fulfilling the following criteria were selected: a) frequency at least twice weekly for > 20 minutes; b) duration > 6 weeks; c) aerobic exercise intensity > 55% of the maximum heart rate and/or muscle strengthening exercises starting at 30% to 50% of one repetition maximum; and d) performed under supervision.
• The RCT included one or more of the following outcome measures: functional ability, aerobic capacity, muscle strength, pain, disease activity or radiological damage.
• Two review authors independently selected eligible studies, rated the methodological quality, and extracted data. A qualitative analysis (best–evidence synthesis) was performed and, where appropriate, a quantitative data analysis (pooled effect sizes).

• In total, eight studies were included in this updated review (two additional studies). Four of the eight studies fulfilled at least 8/10 methodological criteria.
• Short–term, land–based aerobic capacity training, which results show moderate evidence for a positive effect on aerobic capacity.
• Short–term, land–based aerobic capacity and muscle strength training, which results show moderate evidence for a positive effect on aerobic capacity and muscle strength.
• Short–term, water–based aerobic capacity training, which results show limited evidence for a positive effect on functional ability and aerobic capacity.
• Long–term, land–based aerobic capacity and muscle strength training, which results show moderate evidence for a positive effect on aerobic capacity and muscle strength.
• With respect to safety, no deleterious effects were found in any of the included studies.

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