Intensive exercise in rheumatoid arthritis

Long-term high-intensity exercise does not accelerate the progression of joint damage in rheumatoid arthritis patients. Exercise benefits arthritis patients by increasing their physical capacity and functional and emotional ability. Little is, however, known about the damaging effects of exercise on small joints of hands and feet. Researchers from the Leiden University Medical Center studied 309 patients with rheumatoid arthritis who were divided randomly into a high-intensity exercise group or a regular physical exercise. After two years, 136 participants in the high-intensity and 145 in the control exercise group were still in the trial. At that point, the number of damaged joints in the hands and feet increased in both groups and did not differ between them. Three factors were responsible for the rapid increase in joint damage - worse existing damage before the study started, higher disease activity during the study, and decreases rather than increases in aerobic fitness. The findings suggest that participation in a long-term high-intensity weight-bearing exercise program comprising improvement in aerobic fitness and impact-generating activities does not increase the rate of radiological joint damage of the hands and feet in patients with rheumatoid arthritis. On the contrary, it seems that these exercises have a protective effect on the joints of the feet.