Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
, 59 (8), 615-21

Effect of Intensive Exercise on Patients With Active Rheumatoid Arthritis: A Randomised Clinical Trial

Clinical Trial

Effect of Intensive Exercise on Patients With Active Rheumatoid Arthritis: A Randomised Clinical Trial

C H van den Ende et al. Ann Rheum Dis.


Objective: To investigate the effects of a dynamic, intensive exercise regimen on pain, disease activity, and physical functioning in active rheumatoid arthritis (RA).

Methods: 64 patients with RA with a mean age of 60 (13) years and mean disease duration of 8 (8) years, admitted to hospital because of active disease, were randomly assigned to an intensive exercise programme or to a conservative exercise programme during their period in hospital with a mean length of 30 (14) days. The intensive exercise programme consisted of knee and shoulder dynamic and isometric muscle strengthening exercises against resistance five times a week and conditioning bicycle training three times a week and was supplemental to the conservative exercise programme of range of motion and isometric exercises. Indices of disease activity, pain, muscle strength, and functional ability were assessed at 0, 3, 6, 12, and 24 weeks by a blinded observer.

Results: The medical treatment during the study was the same in both groups. Both groups improved in measures of disease activity, differences between groups were not statistically significant. The mean improvement in disease activity score at 24 weeks in the intensive and conservative exercise group was -1.4 (1. 5) and -0.7 (1.4), respectively. Measures of physical functioning improved significantly for patients in the intensive exercise group, and differences between groups were statistically significant for measures of muscle strength.

Conclusion: A short term intensive exercise programme in active RA is more effective in improving muscle strength than a conservative exercise programme and does not have deleterious effects on disease activity.


Figure 1
Figure 1
Flow chart of the number of patients who completed the study according to the protocol and the number of patients who did not complete the allocated treatment or were lost to follow up.
Figure 2
Figure 2
Mean values of variables of (A) pain measured by a visual analogue scale (VAS); (B) disease activity score (DAS); (C) muscle strength; and (D) functional ability at 0, 3, 6, 12, and 24 weeks in patients randomly assigned to the conservative exercise group and the intensive exercise group.

Comment in

Similar articles

See all similar articles

Cited by 33 PubMed Central articles

See all "Cited by" articles


    1. Arch Phys Med Rehabil. 1995 Feb;76(2):190-201 - PubMed
    1. Br J Rheumatol. 1998 Jun;37(6):677-87 - PubMed
    1. Br J Rheumatol. 1996 May;35(5):475-82 - PubMed
    1. J Rheumatol. 1994 Mar;21(3):501-4 - PubMed
    1. Clin Exp Rheumatol. 1990 Sep-Oct;8(5):491-4 - PubMed

Publication types