Abdel-Aal Nabil M, Kamil Ragia M, Tayel Dalia I, Hamed Rania H, Ragab Mohamed M, Abd El-Azeim Alshaymaa S
Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Department of Nutrition, High institute of public health Alexander University, Alexandria, Egypt.
Physiother Theory Pract. 2025 Mar;41(3):571-587. doi: 10.1080/09593985.2024.2358122. Epub 2024 May 28.
People with rheumatoid arthritis (RA) frequently use dietary interventions such as Mediterranean diet (MedDiet) and exercises to complement pharmacotherapy.
To investigate the effect of adding MedDiet to a designed exercise program on quadriceps and hamstrings muscles performance, pain, C-reactive protein (CRP), handgrip strength, bodyweight, and function in females with RA.
Sixty females were allocated randomly to the MedDiet plus exercise program ( = 30) or exercise program only ( = 30). The interventions continued for 6 months followed by 6 months of follow-up with no intervention. The primary outcome was the quadriceps and hamstrings muscles performance (agonist-antagonist ratio). The secondary outcomes were visual analog scale (VAS) for pain, CRP blood marker for inflammation, handheld dynamometer for handgrip strength, Health AssessmentQuestionnaire disability index (HAQ-DI) for function, and body weight. All outcomes were measured at baseline, 6-month post-intervention, and 12 months from baseline as a follow-up.
The MedDiet group showed statistically significant improvements in all the measured outcomes than the control group ( < .05) after 6 and 12 months. After 6 months of intervention, the mean±SD for agonist-antagonist ratio, pain, and HAQ-DI were 84.59 ± 5.33 and 69.92 ± 5.56 ( < .001, ƞ = 0.65), 42.33 ± 8.98 and 54.33 ± 10.06 ( < .001, ƞ = 0.3), 1.13 ± 0.48 and 1.9 ± 0.59 ( < .001, ƞ = 0.34) in the MedDiet and control groups, respectively.
Adding MedDiet to aerobic and strengthening exercise program improved quadriceps and hamstrings muscles performance, pain, functional ability, CRP, handgrip strength, and body weight. Consequently, Mediterranean diet should be considered as adjunctive therapy in treating females with RA.
类风湿关节炎（RA）患者经常采用饮食干预措施，如地中海饮食（MedDiet）和运动，以辅助药物治疗。
研究在一项设计好的运动计划中加入地中海饮食对类风湿关节炎女性患者股四头肌和腘绳肌的肌肉表现、疼痛、C反应蛋白（CRP）、握力、体重及功能的影响。
60名女性被随机分为地中海饮食加运动计划组（n = 30）和仅运动计划组（n = 30）。干预持续6个月，随后进行6个月的无干预随访。主要结局指标是股四头肌和腘绳肌的肌肉表现（主动肌-拮抗肌比率）。次要结局指标包括疼痛视觉模拟量表（VAS）、炎症的CRP血液标志物、握力计测量的握力、功能的健康评估问卷残疾指数（HAQ-DI）和体重。所有结局指标在基线、干预后6个月以及基线后12个月随访时进行测量。
6个月和12个月后，地中海饮食组在所有测量结局指标上均比对照组有统计学显著改善（P < 0.05）。干预6个月后，地中海饮食组和对照组的主动肌-拮抗肌比率、疼痛及HAQ-DI的均值±标准差分别为84.59 ± 5.33和69.92 ± 5.56（P < 0.001，η = 0.65）、42.33 ± 8.9和54.33 ± 10.06（P < 0.001，η = 0.3）、1.13 ± 0.48和1.9 ± 0.59（P < 0.001，η = 0.34）。
在有氧运动和强化运动计划中加入地中海饮食可改善股四头肌和腘绳肌的肌肉表现、疼痛、功能能力、CRP、握力和体重。因此，地中海饮食应被视为治疗类风湿关节炎女性患者的辅助疗法。
