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Rheumatoid Arthritis and Aerobic Exercise

Physical Exam and History

Some physical findings of particular interest due to the diagnosis include:

• morning stiffness lasting from ten minutes to over an hour
• general strength of 4/5 (80% of normal)
• metatarsalgia
• deformity of toes of both feet
• swan-necking and ulnar deviation of the fingers of both hands
• swelling of various joints

Through the course of her disease, Jody has been on many different medications, including:

• A variety of NSAIDS (non-steroidal anti-inflammatory drugs)
• DMARDs (disease modifying anti-rheumatic disease) e.g. plaquinel, oral gold
• Medications for gastrointestinal problems: Cytotec®, Zantac®
• Pharmaceuticals for fibromyalgia: Elavil®, amitryptyline
• Prednisone for inflammatory flares

Due to muscular weakness, joint stiffness, fatigue, decreased endurance, disturbed sleep, and depression, the doctor also ordered exercise.

Jody consulted a physical therapist and she began to participate in an exercise research project and then in a community-based exercise program.

What is the evidence of benefits and safety for aerobic exercise and strengthening for patients with RA?