Rhmatoid Arthritis
Arthritis & Rheumatism (Arthritis Care & Research)
Vol. 49, No. 3, June 15, 2003, pp 428 – 434
DOI 10.1002/art.11051
© 2003, American College of Rheumatology
SPECIAL ARTICLE
Evidence for the Benefit of Aerobic and
Strengthening Exercise in Rheumatoid Arthritis
¨
CHRISTINA H. STENSTROM1
AND
MARIAN A. MINOR2
Introduction
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology. It usually presents as symmetric polyarthritis, but also confers general inflammatory symptoms. RA is present in 0.5–1% of the general population, twice as often in women, and the age at disease onset is mainly between 45 and 65 years. The American College of Rheumatology (formerly American Rheumatism Association [ARA]) has suggested diagnostic criteria (1) for RA. The disease course varies and prediction of the prognosis is difficult in any particular case. In the long run, a reduced function, difficulties in activities of daily living (ADL), and a negative psychosocial impact are often seen. RA also is connected with increased risk for osteoporosis (2), cardiovascular disease, and premature death (3). Criteria for the classification of functional loss have been suggested (4). Functional class (FC) I includes individuals without difficulties in daily life, FC II includes those with symptoms but minor limitations only, FC III includes those who are partly dependent, and FC IV includes those who are totally dependent on other persons in daily life. The vast majority of individuals with RA belong to FC II.
Pain, stiffness, and fatigue generally occur early in the course of RA. Reduction of body function, such as range of motion (ROM), muscle strength, and aerobic capacity, may follow. As previously summarized by van den Ende et al
(5), 50% of patients with RA displayed decreased hand
ROM at their first rheumatology visit. Two years later, reduced ROM was found in large joints; the decreased
ROM varied between 25% and 35% in
Vol. 49, No. 3, June 15, 2003, pp 428 – 434
DOI 10.1002/art.11051
© 2003, American College of Rheumatology
SPECIAL ARTICLE
Evidence for the Benefit of Aerobic and
Strengthening Exercise in Rheumatoid Arthritis
¨
CHRISTINA H. STENSTROM1
AND
MARIAN A. MINOR2
Introduction
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology. It usually presents as symmetric polyarthritis, but also confers general inflammatory symptoms. RA is present in 0.5–1% of the general population, twice as often in women, and the age at disease onset is mainly between 45 and 65 years. The American College of Rheumatology (formerly American Rheumatism Association [ARA]) has suggested diagnostic criteria (1) for RA. The disease course varies and prediction of the prognosis is difficult in any particular case. In the long run, a reduced function, difficulties in activities of daily living (ADL), and a negative psychosocial impact are often seen. RA also is connected with increased risk for osteoporosis (2), cardiovascular disease, and premature death (3). Criteria for the classification of functional loss have been suggested (4). Functional class (FC) I includes individuals without difficulties in daily life, FC II includes those with symptoms but minor limitations only, FC III includes those who are partly dependent, and FC IV includes those who are totally dependent on other persons in daily life. The vast majority of individuals with RA belong to FC II.
Pain, stiffness, and fatigue generally occur early in the course of RA. Reduction of body function, such as range of motion (ROM), muscle strength, and aerobic capacity, may follow. As previously summarized by van den Ende et al
(5), 50% of patients with RA displayed decreased hand
ROM at their first rheumatology visit. Two years later, reduced ROM was found in large joints; the decreased
ROM varied between 25% and 35% in