# Exercise as it relates to Disease/Does resistance training help with rheumatoid arthritis?

This page is a critique of the article 'The effects of progressive resistance training in rheumatoid arthritis' written by Laura C. Rall, Simin Nikbin Meydani, Joseph J. Kehayias, Bess Dawson-Hughes and Ronenn Roubenoff. Conducted by the American college of Rheumatology

## Background of this research

Rheumatoid arthritis is a common autoimmune disease that is associated with disability, early death and socioeconomic cost.<ref=name"McInnes">McInnes L. (2011)'The Pathogenesis of Rheumatoid Arthritis. The New England Journal of medicine vol 365 pp 2205-19</ref> It is shown in this study that the cause rheumatoid arthritis is still unknown. The goal of this article is to see if resistance training helps with rheumatoid arthritis. Rheumatoid arthritis attacks the synovial fluids of joints. It is shown that progressive resistance training increases muscle density, mass and function with participants suffering from Rheumatoid Arthritis. The purpose of this study is to see the effect of progressive resistance training without changing energy balance or body composition. Rheumatoid arthritis is a very common diseases that affects many people in the real world. A study done shows that out of 3501 subjects with rheumatoid arthritis, 922 patients died within 35 years of the initial test. So this study helps to educate people suffering from rheumatoid arthritis and to in-turn increase their state of life.

## Where is this research from

This research is conducted by the American College of Rheumatology vol 39 pp 415–426. It was conducted in 1996. The research was also published by the American College of Rheumatology.
Rheumatoid Arthritis- is a autoimmune diseases that attacks the synovial fluids within the joints of the body which degrades it down and makes the bones rub together. This causing pain and discomfort in the subject.

## What kind of research was this

This research was a randomized control group. With intervention protocols in place. The participants with rheumatoid arthritis were enlisted from the New England Medical center and from other Boston clinics.

## What did this research involve

This research consisted of 30 subjects. These include 8 untrained subjects with rheumatoid arthritis, 8 untrained healthy young subjects and 14 untrained elderly subjects. All healthy young subjects and rheumatoid arthritis subjects were put into a 12 week strength program. While the elderly group were assigned to either a strength group or a non strength group. Participants assigned to the 12 week strength program would participate in a dynamic exercise program occurring twice a week with resistance set at 80% of their 1 rep maximum. While the elderly group only did warm up exercises instead. The researches took 2 different recordings. One which was the baseline recording and one which was the follow up recording after. The exercises included in the research were Chest press, Leg press, Leg extension, Back extension and abdominal curl. This research also included 3 other areas that were tested. These were fitness levels, clinical outcomes and dietary intake and body composition.

## What were the basic results

The results have shown that the elderly group and the group suffering from rheumatoid arthritis shown significantly less strength than the young exercise group. However results have shown that all 3 of these groups shown increased strength from baseline to follow up recordings on all machines.There was no difference in terms of body wight, BMI (body mass index) and hemoglobin levels among the subjects of all 3 groups. The fitness part of this research showed that the younger exercise group had a higher VO2 max. After taking into account for body cell mass it was shown that the younger group could exercise for longer at both baseline and at follow up. There were no significantly increases in fitness levels because there was no fitness interventions put in place The clinical outcomes shown that patients with self diagnosed pain and fatigues shown reduced self diagnosed pain. The dietary intake section of this research shown no differences between protein intake per kilogram of body between the groups at baseline and follow up. Although the increase in strength among the participants there was no significant changes in body composition.
The researched only put into place interventions for the strength section of this paper. There were no interventions for the other 3 sections of the paper. This is because they were looking at the benefits of resistance training on rheumatoid arthritis than the other sections. The way they interpreted the data was by putting the data into graphs and tables. They measured the results from baseline recording and from follow up recordings. They then compared the 2 results against each other and recorded the difference between the two.
Results of the 12 week strength program :
| Exercise | Baseline | Follow up | % difference |
| Chest press |
| RA ± | 8.3 ± 4.9 | 12.3 ± 6.1 | 54.0 ± 32.2 |
| Leg press |
| RA ± | 24.7 ± 8.6 | 41.0 ± 9.1 | 74.8 ± 39.39 |
| Leg extension |
| RA ± | 27.7 ± 10.3 | 41.0 ± 12.1 | 53.5 ± 30.4 |
| Back extension |
| RA ± | 32.6 ± 14.0 | 47.0 ± 8.4 | 58.3 ± 42.0 |
| Abdominal curl |
| RA ± | 15.6 ± 5.1 | 23.9 ± 7.7 | 56.9 ± 33.7 |
RA = Rheumatoid arthritis
As you can see from the results above. The participants increased majorly over the baseline recordings versus the follow up recordings. This shows that a 12 week strength program using resistance increases the participants strength even if they are suffering from rheumatoid arthritis

## What conclusions can we take from this research

In this research it is shown that there is a significant increase in strength when subjects with rheumatoid arthritis partake in resistance training. There was also a decrease in self diagnosed pain and fatigue between the participants with rheumatoid arthritis. Another study done shows that progressive resistance training also improved participants with rheumatoid arthritis in multiple measures. In conclusion people suffering from rheumatoid arthritis should start exercise and proceed with doing resistance training. However if further pain occurs stop and seek a qualified medical practitioner.

## Practical Advice

* This article shows that resistance training does help with people suffering from rheumatoid arthritis
* Personal trainers at gym are a highly recommended option to help assist people in participating in resistance training
* See an allied health professional before commencing in resistance training
* Follow up set workout plan instead of going in unplanned

## Further information/resources

* Knowledge of rheumatoid arthritis- https://www.arthritis.org/diseases/rheumatoid-arthritis
* Exercise ideas for rheumatoid arthritis- https://arthritisaustralia.com.au/managing-arthritis/living-with-arthritis/physical-activity-and-exercise/exercise-and-ra/
* Water aerobics for rheumatoid arthritis- https://arthritisaustralia.com.au/managing-arthritis/living-with-arthritis/physical-activity-and-exercise/water-exercise/

## References

* ↑ Rall C.(1996)'The effects of progressive resistance training in rheumatoid arthritis, American college of Rheumatology vol 39 pp 415-426
* ↑ McInnes L. (2011)'The Pathogenesis of Rheumatoid Arthritis. The New England Journal of medicine vol 365 pp 2205-19
* ↑ Alamanos Y. (2005)'Epidemiology of adult rheumatoid arthritis. Department of Hygiene and Epidemiology vol 4 pp 130-136
* ↑ Lemmey A. (2009)'Effects of high-Intensity Resistance Training in Patients With Rheumatoid Arthritis, American College of Rheumatology vol 61 pp 1726-1734
* ↑ Wolfe F. (1994) ' The Mortality of Rheumatoid Arthritis, American college of Rheumatology vol 37 pp 481-494
* ↑ Morsley K. (2018)'progressive resistance training (PRT) improves rheumatoid arthritis outcomes vol 16 pp 13-17