van den Ende C H, Hazes J M, le Cessie S, Mulder W J, Belfor D G, Breedveld F C, Dijkmans B A
University Hospital Leiden, The Netherlands, Department of Rheumatology.
Ann Rheum Dis. 1996 Nov;55(11):798-805. doi: 10.1136/ard.55.11.798.
To investigate the benefit of intensive dynamic exercises in comparison to range of motion (ROM) and isometric exercises in rheumatoid arthritis.
100 consecutive rheumatoid arthritis patients on stable medication were randomly assigned to (1) intensive dynamic group exercises which included full weight bearing exercises and conditioning exercises on a stationary bicycle while the heart rate was maintained at 70-85% of the age predicted maximum heart rate, (2) range of motion (ROM) exercises and isometric exercises in a group, (3) individual isometric and ROM exercises, and (4) home instructions for isometric and ROM exercises. Variables of physical condition, muscle strength, joint mobility, daily functioning (HAQ), and disease activity were assessed before and after the 12 week exercise course, and 12 weeks thereafter. An intention to treat analysis was performed.
Increases in aerobic capacity (n = 77), muscle strength, and joint mobility in the high intensity exercise programme were respectively 17%, 17% and 16% and differed significantly from the changes in aerobic capacity, muscle strength, and joint mobility in the other exercise groups. No deterioration of disease activity was observed. Twelve weeks after discontinuation of the exercise course the gain in physical capacity had disappeared.
Intensive dynamic training is more effective in increasing aerobic capacity, joint mobility, and muscle strength than ROM exercises and isometric training in rheumatoid arthritis patients with well controlled disease.
探讨与类风湿关节炎的关节活动度（ROM）练习和等长运动相比，强化动态运动的益处。
100名连续服用稳定药物的类风湿关节炎患者被随机分为四组：（1）强化动态团体运动组，包括全负重运动和在健身自行车上进行的调节运动，同时心率维持在年龄预测最大心率的70 - 85%；（2）一组进行关节活动度（ROM）练习和等长运动；（3）进行个体等长运动和ROM练习；（4）给予等长运动和ROM练习的家庭指导。在12周运动课程前后以及此后12周，对身体状况、肌肉力量、关节活动度、日常功能（健康评估问卷，HAQ）和疾病活动度等变量进行评估。进行意向性分析。
高强度运动方案组的有氧运动能力（n = 77）、肌肉力量和关节活动度分别提高了17%、17%和16%，与其他运动组的有氧运动能力、肌肉力量和关节活动度变化有显著差异。未观察到疾病活动度恶化。运动课程停止12周后，体能增加消失。
对于疾病得到良好控制的类风湿关节炎患者，强化动态训练在提高有氧运动能力、关节活动度和肌肉力量方面比ROM练习和等长训练更有效。
