Effects of a Group-Based Exercise and Educational Program on Physical Performance and Disease Self-Management in Rheumatoid Arthritis: A Randomized Controlled Study

• Published in: Physical therapy 2011-06, Vol.91 (6), p.879-893
• Main Authors: Breedland, Ineke, van Scheppingen, Corinne, Leijsma, Martha, Verheij-Jansen, Nienke P, van Weert, Ellen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analysis; Arthritis, Rheumatoid - physiopathology; Arthritis, Rheumatoid - rehabilitation; Behavior; Care and treatment; Data collection; Education; Exercise; Exercise Therapy; Female; Health aspects; Health Behavior; Health education; Health Status; Humans; Intervention; Lower Extremity - physiopathology; Male; Middle Aged; Mortality; Muscle Strength; Muscle Strength Dynamometer; Older people; Oxygen Consumption; Patient Education as Topic; Physiological aspects; Rheumatoid arthritis; Self Care; Self Efficacy; Self-care, Health; Sports training; Studies; Upper Extremity - physiopathology; Young Adult
• ISSN: 0031-9023; 1538-6724
• DOI: 10.2522/ptj.20090010

Evidence supports the use of educational and physical training programs for people with rheumatoid arthritis (RA). The purpose of this study was to evaluate the effects of a group-based exercise and educational program on the physical performance and disease self-management of people with RA. This was a randomized controlled trial. The study was conducted at a rehabilitation center in the Netherlands. Thirty-four people diagnosed with RA participated in the study. Participants were randomly assigned to either an intervention group (n=19) or a waiting list control group (n=15). The intervention in this study was an 8-week, multidisciplinary, group therapy program for people with RA, consisting of physical exercise designed to increase aerobic capacity and muscle strength (force-generating capacity) together with an educational program to improve health status and self-efficacy for disease-self-management. The main outcome measures were maximum oxygen uptake (Vo(2)max), muscle strength of the elbow and knee flexors and extensors, health status, and perceived self-efficacy. All data were recorded before intervention in week 1, after intervention in week 9, and at follow-up in week 22. The intervention group showed significant improvement (12.1%) in Vo(2)max at week 9 compared with the control group (-1.7%). Although significant within-group changes were found over time for muscle strength of the upper and lower extremities and health status that favored the intervention group, no between-group changes were found regarding these outcomes. An important limitation was the small number of participants included in our study, which may have resulted in a lack of power. The present group-based exercise and educational program for people with RA had a beneficial effect on aerobic capacity but not on muscle strength, health status, or self-efficacy.