The Effects of Aerobic and Resistance Exercise on Markers of Large Joint Health in Stable Rheumatoid Arthritis Patients: A Pilot Study

Musculoskeletal Care. 2015 Dec;13(4):222-35. doi: 10.1002/msc.1103. Epub 2015 May 12.


Objective: Exercise is beneficial for people with rheumatoid arthritis (RA). However, patients and health professionals have expressed concern about the possible detrimental effects of exercise on joint health. The present study investigated the acute and chronic effects of high-intensity, low-impact aerobic and resistance exercise on markers of large joint health in RA.

Methods: Eight RA patients and eight healthy, matched control (CTL) participants performed 30 minutes' high-intensity, low-impact aerobic and lower-body resistance exercise, one week apart. Primary outcome measures assessing joint health were serum cartilage oligomeric matrix protein (sCOMP) and knee joint synovial inflammation (Doppler ultrasound colour fraction; CF). These measures were taken at baseline, immediately after and 0.5, one, two, six and 24 hours post-exercise. In a separate study, nine RA patients completed eight weeks of progressive exercise training. The same outcome measures were reassessed at baseline, and at one hour post-exercise of training weeks 0, 1, 4 and 8.

Results: RA patients showed higher overall sCOMP [RA: 1,347 ± 421, CTL: 1,189 ± 562 ng/mL; p < 0.05; effect size (ES) = 0.32] and CF when scanned longitudinally (RA: 0.489 ± 0.30 × 10(-3) , CTL: 0.101 ± 0.13 × 10(-3) ; p < 0.01; ES = 1.73) and transversely (RA: 0.938 ± 0.69 × 10(-3) , CTL: 0.199 ± 0.36 × 10(-3) ; p < 0.01; ES = 1.33) than CTL. However, no acute effects on joint health were observed post-exercise. Similarly, no chronic effects were observed over eight weeks of combined aerobic and resistance training in RA, with positive effects on physical fitness and function.

Conclusions: RA patients on stable treatment with low disease activity were able to perform an individually prescribed high-intensity, low-impact aerobic and resistance exercise without changes in markers of large joint health. Copyright © 2015 John Wiley & Sons, Ltd.

Keywords: Physical activity; cartilage oligomeric matrix protein; synovial inflammation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / physiopathology*
  • Cartilage Oligomeric Matrix Protein / blood
  • Female
  • Humans
  • Joints / pathology
  • Joints / physiopathology*
  • Male
  • Middle Aged
  • Pilot Projects
  • Resistance Training*


  • COMP protein, human
  • Cartilage Oligomeric Matrix Protein