Authors: A. Bilberg, M. Ahlmén, and K. Mannerkorpi By: Marc Bari Moderately intensive exercise in a temperate pool for patients with rheumatoid arthritis: a randomized controlled study Authors: A. Bilberg, M. Ahlmén, and K. Mannerkorpi By: Marc Bari

What is RA? Rheumatoid Arthritis is a chronic syndrome characterized by non-specific, symmetric inflammation of the peripheral joints, potentially resulting in the progressive destruction of articular and peri-articular structures. Patients with RA experience daily pain, fatigue, stiffness, joint swelling, reduced range of motion in the joints and muscle weakness.

Objective The aim of this study was to evaluate the effects of moderately intensive pool exercise therapy on patients with rheumatoid arthritis (RA).

Population 47 participants – 5 men and 42 female Between 20-65 years old Have had RA for 1-5 yrs Have been on stable medication for the past 3 months Were asked not to start any new medication during the study

Intervention 12 week program Exercised in a temperature pool twice a week Groups of 8 or 9 people 45 minutes sessions Exercises for aerobic capacity, dynamic (eccentric and concentric) and static muscle strength, and muscle endurance in the upperand lower extremities, flexibility, coordination and relaxation

Outcome Measures Aerobic Capacity- using submaximal ergometer cycle Two tests for muscle endurance- one for upper body and one for lower body Chair test and shoulder endurance test Range of motion and functional limitation tests Tested at baseline and then post treatment (3 months)

Results No improvement in aerobic capacity Improvement in muscle endurance and flexibility Significant improvement in overall body pain and functional movement Increased shoulder joint ROM

Relevance Individuals with RA have been shown to have decreased level of physical activity because of their various uncomfortable symptoms. They have also been shown to have decreased muscular strength, endurance, and aerobic capacity. By implementing an exercise program in a pool that takes stress away from the joints, it can help these individuals with RA increase their physical activity levels.

Opinion I think this article was successful in showing the benefits a pool exercise program can have for people with RA. An exercise program in a temperature controlled pool environment allows patients with RA to exercise and remain physically active while avoiding stress on their joints which may already be inflamed.

Reference A. Bilberg, M. Ahlmén, and K. Mannerkorpi Moderately intensive exercise in a temperate pool for patients with rheumatoid arthritis: a randomized controlled studyRheumatology (2005) 44 (4): 502-508 first published online February 22, 2005doi:10.1093/rheumatology/keh528