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Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis

Hurkmans E, van der Giesen FJ, Vliet Vlieland TPM, Schoones J, Van den Ende ECHM
Published Online: 
7 October 2009

This summary of a Cochrane review presents what we know from research about the effect of exercise on Rheumatoid Arthritis (RA). 

The review shows that in people with rheumatoid arthritis:

- Aerobic exercise and muscle strength training on land probably improve pain and physical function slightly in the short term. 

- There were no harmful side effects (such as increased pain or damage to your joints) of exercise found in this review.  This was true for exercising on land or in the water, although most of the studies were not long enough to tell if exercise might cause joint damage.

What is dynamic exercise and what is rheumatoid arthritis?

Dynamic exercise therapy programs means activities with enough intensity, duration, and frequency to improve stamina or muscle strength.   Exercise can be any activity that enhances physical fitness. Exercise which gives you more energy, endurance or stamina is often called aerobic exercise.  People exercise for many different reasons including weight loss, strengthening muscles and for general fitness.

When you have rheumatoid arthritis, your immune system, which normally fights infection, attacks the lining of your joints. This makes your joints swollen, stiff and painful. The small joints of your hands and feet are usually affected first. There is no cure for RA at present, so treatments such as exercise aim to relieve pain and stiffness and improve your ability to move. 

Best estimate of what happens to people with rheumatoid arthritis who take part in a short term land-based dynamic exercise program:

Pain (higher scores mean worse or more severe pain)

- People who took part rated their pain to be about half a point lower on a scale of 0 to 10 after 12 weeks (6% absolute improvement).
- People who took part in a dynamic exercise program rated their pain to be about half a point on a scale of 0 to 10.
- People who did not exercise rated their pain to be 1 on a scale of 0 to 10. 


Physical Function (higher score means worse physical function)

- People who took part rated their physical function to be about half a point lower on a scale of 0 to 3 after 12 weeks (6% absolute improvement).
- People who took part in a dynamic exercise program rated their physical function to be about 1.5 on a scale of 0 to 3.
- People who did not exercise rated their physical function to be 1 on a scale of 0 to 3. 

This record should be cited as: 
Hurkmans E, van der Giesen FJ, Vliet Vlieland TPM, Schoones J, Van den Ende ECHM. Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD006853. DOI: 10.1002/14651858.CD006853.pub2
Assessed as up to date: 
17 June 2009