June 27, 2005

Exercise Reverses Arthritis-Related Wasting

NEW YORK -- Progressive resistance training can help patients with rheumatoid arthritis who experience muscle wasting, researchers report.

"Generalized muscle wasting in rheumatoid arthritis is common although often masked by a concomitant increase in fat mass," Dr. Samuele M. Marcora told Reuters Health. "Our preliminary study suggests that progressive resistance training is an effective treatment for this metabolic complication of rheumatoid arthritis."

As reported in the Journal of Rheumatology, Marcora from University of Wales-Bangor, UK, and colleagues investigated the value of progressive resistance training (PRT) in 20 patients with rheumatoid arthritis and loss of muscle mass.

Ten of the patients participated in 12 weeks of PRT, consisting of thrice-weekly sessions that included eight resistance exercises per session. The other 10 patients continued their usual care without additional PRT.

Progressive resistance training significantly increased lean body mass and fat-free mass without altering total body weight, the researchers report. Hand-grip strength, elbow flex strength, and 30-second sit-to-stand test results increased significantly among patients who underwent PRT.

Although the training did not affect overall quality of life, the researchers note, participants reported less difficulty in advanced activities of daily living.

PRT did not cause any arthritis flare-ups or injuries, the results indicate, and training did not significantly affect any measures of disease activity.

Any patient with rheumatoid arthritis should undertake low-impact, moderate intensity exercise, Marcora advised, but not necessarily the intensive training used in this study.

"The intense PRT program we used to stimulate muscle growth in rheumatoid arthritis patients should probably be treated as a 'pharmacological' form of exercise and prescribed only to patients with severe (muscle wasting)," he explained.

Nonetheless, "Any patient with low to moderate disease activity can undertake this level of progressive resistance training," he said.

"Although very intense on muscles, PRT is actually a low-impact activity in terms of forces imposed on the joints when performed correctly," Marcora pointed out. "This is why it is very important that patients are initially supervised and appropriately instructed by a clinical exercise physiologist."

SOURCE: Journal of Rheumatology, June 2005.