Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results of a randomised clinical trial. Dynamic versus static training in patients with rheumatoid arthritis. Effects of a Group-Based Exercise and Educational Program on Physical Performance and Disease Self-Management in Rheumatoid Arthritis: A Randomized Controlled Study A HOME-BASED MULTIDIMENSIONAL EXERCISE PROGRAM REDUCED PHYSICAL IMPAIRMENT AND FEAR OF FALLING Long-term follow-up of a high-intensity exercise program in patients with rheumatoid arthritis Muscle function in aged women in response to a water-based exercises program and progressive resistance training. Moderately intensive exercise in a temperate pool for patients with rheumatoid arthritis: a randomized controlled study. Long-term resistance training in the elderly: effects on dynamic strength, exercise capacity, muscle, and bone. Jumping combined exercise programs reduce fall risk and improve balance and life quality of elderly people who live in a long-term care facility. Improvement in Aerobic Capacity After an Exercise Program in Sporadic Inclusion Body Myositis Adherence and satisfaction of rheumatoid arthritis patients with a long-term intensive dynamic exercise program (RAPIT program). Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Slowing of bone loss in patients with rheumatoid arthritis by long-term high-intensity exercise: results of a randomized, controlled trial. Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews Intensive aerobic and muscle endurance exercise in patients with systemic sclerosis: a pilot study The effectiveness of aerobic and muscle strength training in patients receiving hemodialysis and EPO: a randomized controlled trial. Effect of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial Effects of Low-Impact, Moderate-Intensity Exercise Training with and without Wrist Weights on Functional Capacities and Mood States in Older Adults Effects of detraining subsequent to strength training on neuromuscular function in patients with inflammatory arthritis. Long-term impact of strength training on muscle strength characteristics in older adults. Effect of discontinuation of alendronate treatment and exercise on bone mass and physical fitness: 15-month follow-up of a randomized, controlled trial. Do Yoga and Aerobic Exercise Training Have Impact on Functional Capacity, Fatigue, Peripheral Muscle Strength, and Quality of Life in Breast Cancer Survivors? Rehabilitation in rheumatoid arthritis: a critical review.
OBJECTIVE : To investigate the benefit of intensive dynamic exercises in comparison to range of motion ( ROM ) and isometric exercises in rheumatoid arthritis . METHODS : 100 consecutive rheumatoid arthritis patients on stable medication were r and omly 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 . RESULTS : 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 . CONCLUSIONS : 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 Sixty-seven patients with classical or definite rheumatoid arthritis ( RA ) were studied concerning the effects of st and ardized physical training on muscle function in the lower extremities . The patients were r and omly assigned to four different training groups and were given 6 weeks of training supervised by a physiotherapist at a health care centre . The groups differed according to type ( dynamic or static ) and extent ( 12 or 4 times ) of training . During this training period as well as for an additional 3 months , the patients carried out programs of exercise at home ( either dynamic or static ) . A significantly greater increase in function during the 6-week period as regards muscle strength , endurance , aerobic capacity , and functional ability was found for the dynamic as compared with the static groups . The findings at follow-up 3 months later were similar . The effectiveness of the programs did not vary with the extent of training . In conclusion , in RA patients , dynamic training gives a greater increase in physical capacity than does static training Background Evidence supports the use of educational and physical training programs for people with rheumatoid arthritis ( RA ) . Objective The purpose of this study was to evaluate the effects of a group-based exercise and educational program on the physical performance and disease self-management of people with RA . Design This was a r and omized controlled trial . Setting The study was conducted at a rehabilitation center in the Netherl and s. Participants Thirty-four people diagnosed with RA participated in the study . Participants were r and omly assigned to either an intervention group ( n=19 ) or a waiting list control group ( n=15 ) . Intervention The intervention in this study was an 8-week , multidisciplinary , group therapy program for people with RA , consisting of physical exercise design ed to increase aerobic capacity and muscle strength ( force-generating capacity ) together with an educational program to improve health status and self-efficacy for disease-self-management . Measurements The main outcome measures were maximum oxygen uptake ( V̇o2max ) , muscle strength of the elbow and knee flexors and extensors , health status , and perceived self-efficacy . All data were recorded before intervention in week 1 , after intervention in week 9 , and at follow-up in week 22 . Results The intervention group showed significant improvement ( 12.1 % ) in V̇o2max at week 9 compared with the control group ( −1.7 % ) . Although significant within-group changes were found over time for muscle strength of the upper and lower extremities and health status that favored the intervention group , no between-group changes were found regarding these outcomes . Limitations An important limitation was the small number of participants included in our study , which may have result ed in a lack of power . Conclusions The present group-based exercise and educational program for people with RA had a beneficial effect on aerobic capacity but not on muscle strength , health status , or self-efficacy Abstract Objective . To investigate the efficacy of a guided and grade d home-based exercise program for improving a range of physical outcomes in older people . Design . Controlled clinical trial of 16 weeks Setting . Two geographical areas in Gent , Belgium Participants . 66 independent-living older people ( age : 71 - 98 ) with a history of falls and moderate physical impairment Intervention . Twenty-four 30-minute training sessions were given by a trained physiotherapist over a period of 16 weeks in the participant ’s home . Different types of exercises on balance , aerobic performance , flexibility , and muscle strength were provided . Main outcome measures . Muscle strength , static and dynamic balance , aerobic performance , activities in daily living , fear of falling and avoidance of daily activities were assessed at baseline and after 16 weeks intervention . Results : At baseline , there were no significant differences in the measured variables between exercise and control groups . After 16 weeks , the exercise group showed significantly improved ankle muscle strength , balance performance and aerobic capacity , and decreased fear of falling , dependency in daily activities and avoidance of daily activities compared to the control group . The improvements in knee muscle strength , timed chair st and s , and functional reach were not significant . Conclusion : The home-based , individualized exercise program was effective in reducing several physical factors associated with falls in community-dwelling older people with moderate physical impairment . The decrease in fear of falling and other behavioural variables needs to be considered with care and needs further investigation The aims of this study were to describe rheumatoid arthritis patients ’ compliance with continued exercise after participation in a 2-year supervised high-intensity exercise program  and to investigate if the initially achieved effectiveness and safety were sustained . Data were gathered by follow-up of the participants who completed the 2-year high-intensity intervention in a r and omized controlled trial ( Rheumatoid Arthritis Patient In Training study ) . Eighteen months thereafter , measurements of compliance , aerobic capacity , muscle strength , functional ability , disease activity , and radiological damage of the large joints were performed . Seventy-one patients were available for follow-up at 18 months , of whom 60 ( 84 % ) were still exercising ( exercise group : EG ) , with average similar intensity but at a lower frequency as the initial intervention . Eleven patients ( 16 % ) reported low intensity or no exercises ( no-exercise group : no-EG ) . Patients in the EG had better aerobic fitness and functional ability , lower disease activity , and higher attendance rate after the initial 2-year intervention . At follow-up , both groups showed a deterioration of aerobic fitness and only patients in the EG were able to behold their muscle strength gains . Functional ability , gained during the previous participation in high-intensity exercises , remained stable in both groups . Importantly , no detrimental effects on disease activity or radiological damage of the large joints were found in either group . In conclusion , the majority of the patients who participated in the 24-month high-intensity exercise program continued exercising in the ensuing 18 months . In contrast to those who did not continue exercising , they were able to preserve their gains in muscle strength without increased disease activity or progression of radiological damage AIM The purpose of the present study was to determine the effects of a water-based exercise program on muscle function compared with regular high-intensity resistance training . METHODS Older women ( n = 87 ) were recruited from the local community . The inclusion criteria were , to be aged 60 years or older , able to walk and able to carry out daily living activities independently . Participants were r and omly assigned to one of the following groups : water-based exercises ( WBG ) , resistance training ( RTG ) or control ( CG ) . The experimental groups carried out 12 weeks of an excise program performed on water or on l and . The dynamic strength , the isometric peak , and rate of torque development for the lower limbs were assessed before and after interventions . RESULTS The water-based program provided a similar improvement in dynamic strength in comparison with resistance training . The isometric peak torque increased around the hip and ankle joints in the water-based group , and around the knee joint in the resistance-training group ( P < 0.05 ) . The rate of torque development increased only in the water-based group around the hip extensors muscles ( P < 0.05 ) . CONCLUSIONS Water-based programs constitute an attractive alternative to promote relevant strength gains using moderate loads and fast speed movements , which were also effective to improve the capacity to generate fast torques OBJECTIVES The aim of this study was to evaluate the effects of moderately intensive pool exercise therapy on patients with rheumatoid arthritis ( RA ) . METHODS Forty-six patients with chronic RA were r and omly assigned to a treatment group and a control group . The treatment group ( n = 20 ) exercised in a temperate pool twice a week for 12 weeks . The control group ( n = 23 ) continued with their previous activities .  Aerobic capacity , measured by means of a submaximum bicycle test , and the physical component of the SF-36 were chosen as the primary outcome measures . Two tests of muscle endurance were chosen as the secondary outcome measure . Additional functional tests and instruments were included . RESULTS No significant differences between the groups were found for the primary outcome measures . Significant improvements in the following aspects of muscular function ( P < 0.05 ) were found in the treatment group when their performance was compared with that of the control group : isometric shoulder endurance , grip force , dynamic endurance of lower extremities ( chair test ) and muscle function of lower extremities . Significant improvements were also found for vitality ( SF-36 ) compared with the control group . The improvements in the training group were maintained for 3 months . CONCLUSIONS Pool exercise therapy of moderate intensity significantly improved muscle endurance in the upper and lower extremities in patients with RA , while no impact on aerobic capacity was found . However , the study population was small and there is a need for further studies with larger population We examined the effects of 42 weeks of progressive weight-lifting training on dynamic muscle strength , peak power output in cycle ergometry , symptom limited endurance during progressive treadmill walking and stair climbing , knee extensor cross-sectional areas , and bone mineral density and content in healthy males and females aged 60 - 80 years , currently enrolled in a 2-year resistance training program . Subjects were r and omized into either exercise ( EX ) or control ( CON ) groups ( 60 - 70 years : 38 males and 36 females ; 70 - 80 years : 25 males and 43 females ) . EX trained several muscle groups twice per week for 42 weeks at intensities ranging from 50 - 80 % of the load that they could lift once only ( 1 RM ) ; CON did usual daily activities . After the 10 months there was no change in 1 RM strength in CON , but significant gains ( mean increases up to 65 % ) in EX ( no independent age or gender effects ) ; 30 % and 47 % of the increase in 1 RM had occurred by 6 and 12 weeks , respectively . In EX , the 7.1 % increase in peak cycling power output was significantly greater than in CON ( + 1.1 % ) . The 17.8 % improvement in symptom limited treadmill walking endurance was also greater than in CON ( + 3.4 % ) , but the difference between groups during stair climbing was not significant ( EX + 57 % , CON + 33 % ) . The cross-sectional areas of the knee extensors increased significantly by 5.5 % in EX but were unchanged in CON . There were no changes in bone mineral density or content in either group . We conclude that long-term resistance training in older people is feasible and results in increases in dynamic muscle strength , muscle size , and functional capacity AIM The objective of this study was to determine whether regular combined exercise program , which consists strength , stretching and aerobic exercises and additional jumping training , improve balance , fall risk , quality of life and depression status of older people living in a residential care . METHODS A total of 168 residents who live in a long term care facility were screened . The trial began with 78 eligible participants and they were r and omly grouped as combined exercises program ( COM ) group that includes stretching , strength and aerobic exercises , and COM plus jumping ( COMpJ ) group . 66 of the participants finished the trial . The groups were convened three times a week for six weeks . Each group had a warm-up , effective training and a cooling down periods . The total exercising time was no longer than 45 minutes in each group . Berg balance test and Biodex Balance System for the assessment of the dynamic balance and fall risk , short form 36 ( SF 36 ) for the health related quality of life and Geriatric Depression Scale ( GDS ) for evaluation of the depression status were used . RESULTS The balance improvement and fall risk reduction were observed in both of the groups at the end of the trial ; however , the improvements were statistically better in jumping combined group . Also health related quality of life improved in both groups . CONCLUSION Regular group exercise in a long term care facility have several beneficial effects on the elderly residents in regard to balance improvement , fall risk reduction and quality of life . The addition of jumping to strength , stretching and aerobic exercises provides important contributions to balance improvement and fall risk reduction Objectives : The study aim ed to investigate the effects of a combined functional and aerobic exercise program on aerobic capacity , muscle strength , and functional mobility in a group of patients with sporadic inclusion body myositis ( IBM ) . Methods : Aerobic capacity , muscle strength , and functional capacity assessment s were conducted on 7 participants with sporadic IBM before and after a 12-week exercise program , which included resistance exercises and aerobic stationary cycling 3 times per week on alternative days . Results : Aerobic capacity of the group increased significantly by 38 % , and significant strength improvements were observed in 4 of the muscle groups tested ( P < 0.05 ) . The exercise program was well tolerated , and there was no significant change in the serum creatine kinase level after the exercise period . Conclusions : An aerobic exercise program can be safely tolerated by patients with sporadic IBM and can improve aerobic capacity and muscle strength when combined with resistance training . These findings indicate that aerobic and functional muscle strengthening exercise should be considered in the management of patients with IBM OBJECTIVE To evaluate adherence and satisfaction of patients with rheumatoid arthritis ( RA ) in a long-term intensive dynamic exercise program . METHODS A total of 146 RA patients started an intensive ( strength and endurance training for 75 minutes , twice a week , for 2 years ) exercise program ( Rheumatoid Arthritis Patients In Training ) aim ed at improving physical fitness . Program attendance and satisfaction were examined . Additional assessment s at baseline were done to find possible predictors of attendance . RESULTS Median ( interquartile range ) age and disease duration of the patients were 54 ( 45 - 61 ) and 5 ( 3 - 10 ) years , respectively . After 2 years , 118 ( 81 % ) patients still participated in an exercise class . The median attendance rate of all patients was 74 % . Low attendance was weakly associated with high disease activity , low functional ability , and low quality of life at baseline but not with the severity of joint damage at baseline . At the end , 78 % of all participants would ( strongly ) recommend the program to other RA patients . CONCLUSION Adherence and satisfaction of RA patients with an intensive dynamic exercise program over a prolonged time can be high . Disease severity parameters do not strongly predict the compliance of participants in an intensive exercise program BACKGROUND Multiple sclerosis ( MS ) is a major cause of chronic , neurological disability , with a significant long-term disability burden , often requiring comprehensive rehabilitation . OBJECTIVES To systematic ally evaluate evidence from published Cochrane Review s of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS ( pwMS ) , to improve patient outcomes , and to highlight current gaps in knowledge . METHODS We search ed the Cochrane Data base of Systematic Review s up to December 2017 , to identify Cochrane Review s that assessed the effectiveness of organised rehabilitation interventions for pwMS . Two review ers independently assessed the quality of included review s , using the Revised Assessment of Multiple Systematic Review s ( R-AMSTAR ) tool , and the quality of the evidence for reported outcomes , using the GRADE framework . MAIN RESULTS Overall , we included 15 review s published in the Cochrane Library , comprising 164 r and omised controlled trials ( RCTs ) and four controlled clinical trials , with a total of 10,396 participants . The included review s evaluated a wide range of rehabilitation interventions , including : physical activity and exercise therapy , hyperbaric oxygen therapy ( HBOT ) , whole-body vibration , occupational therapy , cognitive and psychological interventions , nutritional and dietary supplements , vocational rehabilitation , information provision , telerehabilitation , and interventions for the management of spasticity . We assessed all review s to be of high to moderate method ological quality , based on R-AMSTAR criteria .Moderate- quality evidence suggested that physical therapeutic modalities ( exercise and physical activities ) improved functional outcomes ( mobility , muscular strength ) , reduced impairment ( fatigue ) , and improved participation ( quality of life ) . Moderate- quality evidence suggested that inpatient or outpatient multidisciplinary rehabilitation programmes led to longer-term gains at the levels of activity and participation , and interventions that provided information improved patient knowledge . Low-qualitty evidence suggested that neuropsychological interventions , symptom-management programmes ( spasticity ) , whole body vibration , and telerehabilitation improved some patient outcomes . Evidence for other rehabilitation modalities was inconclusive , due to lack of robust studies . AUTHORS ' CONCLUSIONS The evidence suggests that regular specialist evaluation and follow-up to assess the needs of patients with all types of MS for appropriate rehabilitation interventions may be of benefit , although the certainty of evidence varies across the different types of interventions evaluated by the review s. Structured , multidisciplinary rehabilitation programmes and physical therapy ( exercise or physical activities ) can improve functional outcomes ( mobility , muscle strength , aerobic capacity ) , and quality of life . Overall , the evidence for many rehabilitation interventions should be interpreted cautiously , as the majority of included review s did not include data from current studies . More studies , with appropriate design , which report the type and intensity of modalities and their cost-effectiveness are needed to address the current gaps in knowledge OBJECTIVE Patients with rheumatoid arthritis ( RA ) are more at risk for the development of osteoporosis and osteoporotic fractures than are their healthy peers . In this r and omized , controlled , multicenter trial , the effectiveness of a 2-year high-intensity weight-bearing exercise program ( the Rheumatoid-Arthritis- Patients -In-Training [ RAPIT ] program ) on bone mineral density ( BMD ) was compared with usual care physical therapy , and the exercise modalities associated with changes in BMD were determined . METHODS Three hundred nine patients with RA were assigned to an intervention group , either the RAPIT program or usual care physical therapy . The primary end points were BMD of the hip and spine . The exercise modalities examined were aerobic fitness , muscle strength , and , as a surrogate for those effects not directly measured by the RAPIT program , attendance rate . RESULTS The data on the 136  RAPIT participants and 145 usual care participants who completed the study were analyzed . The mean rate of decrease in hip BMD , but not in lumbar spine BMD , was smaller in patients participating in the RAPIT program when compared with that in the usual care group , with a mean decrease of 1.6 % ( 95 % confidence interval [ 95 % CI ] 0.8 - 2.5 ) over the first year and 0.5 % ( 95 % CI 1.1 - 2.0 ) over the second year . The change in hip BMD was significantly and independently associated with changes in both muscle strength ( multivariate odds ratio [ OR ] 1.75 , 95 % CI 1.07 - 2.86 ) and aerobic fitness ( OR 1.79 , 95 % CI 1.10 - 2.90 ) , but not with the attendance rate ( OR 1.00 , 95 % CI 0.99 - 1.00 ) . CONCLUSION A long-term high-intensity weight-bearing exercise program for RA patients is effective in slowing down the loss of BMD at the hip . The exercise modalities associated with this effect are muscle strength and aerobic fitness Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made Background No previous studies have examined the effect of intensive exercise in systemic sclerosis patients with pulmonary impairment . The objective of this study was to examine the effect of an eight-week intensive aerobic exercise and muscle endurance training program for patients with systemic sclerosis with 50–100 % of forced vital capacity . Methods A single-subject experimental design with repeated systematic measures during a six week A-phase ( non-interventional baseline period ) and an eight week B-phase ( exercise intervention period ) was used . Three women and one man with median age 66 years and median disease duration of 3.5 years completed aerobic exercise corresponding to 15 on the Borg RPE scale ( strenuous ) and muscular endurance training three times/week . Physical capacity ( six-minute walk test ) , aerobic capacity ( submaximal treadmill test ) and muscle endurance in shoulder and hip flexion ( Functional Index 2 ) were assessed every other week throughout the 14-week study . Activity limitation ( Health Assessment Question naire ) , quality of life ( Short Form 36 ) , Raynaud , Fatigue and Global Health during the recent week ( Visual Analogue Scales ) were assessed at weeks 0 , 6 , 14 . Results Three participants improved significantly in muscular endurance , and two participants improved significantly or clinical ly relevant in aerobic capacity . All other variables remained unchanged , except for a trend towards reduced fatigue . Conclusions This eight week exercise program was largely successful with positive effects on aerobic capacity and muscle endurance . Trial registration Clinical trials.gov Identifier : BACKGROUND Individuals with end-stage renal disease on hemodialysis therapy have reduced aerobic exercise capacity and reduced muscle strength . METHODS This was a single-blind , r and omized , placebo-controlled trial of an exercise intervention in hemodialysis patients administered erythropoietin . The intervention consisted of progressive resisted isotonic quadriceps and hamstrings exercise and training on a cycle ergometer three times weekly for 12 weeks . Individuals in the control group underwent a nonprogressive program of range-of-motion exercises . Both groups were observed for an additional 5 months without intervention . Outcomes were assessed without knowledge of treatment assignment at baseline , 12 weeks , and 5 months . A healthy age- and sex-matched sample provided comparative data . RESULTS Our sample was relatively high functioning , with a mean score on the Physical Function subscale of the Short Form 36 ( SF-36 ) of 76 of 100 . At 12 weeks , there were large and statistically significant differences in favor of the experimental group on the submaximal exercise test ( 14 W ; 95 % confidence interval , 2 to 26 ) and muscle strength ( 45 lb ; 95 % confidence interval , 9 to 81 ) , but not in the 6-minute walk , symptoms question naire , or SF-36 . Differences between the intervention and control groups at 12 weeks were not evident on retesting 5 months after the end of the intervention . Compared with the healthy sample , patients were significantly lower functioning on the submaximal exercise test , muscle strength , and 6-minute walk test at baseline . CONCLUSION In this high-functioning sample , the exercise program improved physical impairment measures , but had no effect on symptoms or health-related quality of life . The impact on patients with a greater degree of physical dysfunction needs to be rigorously studied 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 r and omly 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 This study examined the effects of low-impact , moderate-intensity exercise training with and without wrist weights ( 0.68 kg·wrist–1 ) on functional capacities and mood states in older adults ( age 68.6 ± 5.6 , mean ± SD ) . Twenty-three senior citizens residing in the community were r and omly assigned to wrist weight ( WW ; n = 12 ) and no-wrist weight ( NW ; n = 11 ) exercise groups while 11 matched subjects served as non-exercise controls ( NE ) . Exercise training was performed for 10 weeks , 3 days/week , for 60 min/session and consisted of low-impact aerobic dance ( 50–70 % of maximal heart rate ) combined with exercises to promote muscular fitness , flexibility , and balance . Before and after the intervention , each participant ’s aerobic fitness , muscular strength , flexibility , static and dynamic balance , skinfold thickness , and psychological mood states were assessed under st and ardized testing conditions . Exercise training result ed in significant improvements in peak oxygen uptake , lower extremity muscle strength , and psychological vigor ( p < 0.05 ) but did not affect other fitness components ( p > 0.05 ) . There were no differences between the WW and NW exercise groups for any of the same variables studied ( p > 0.05 ) . No significant pre- to post-test changes were found for the NE control group ( p > 0.05 ) . It is concluded that 10 weeks of low-impact , moderate-intensity exercise training of the type that can be considered well-rounded in nature provides a sufficient stimulus to augment aerobic fitness , beneficially affects leg strength , and increases feelings of vigor in older adults . The present observations indicate that the use of light wrist weights has no beneficial or adverse effects on the measured training outcomes The effects of detraining subsequent to strength training on neuromuscular function were examined in 39 recent-onset rheumatoid arthritis ( RA ) patients . Eighteen age- and sex-matched healthy people ( H ) served as controls . Patients were r and omly allocated either to the experimental group ( PE ) , who carried out progressive strength training for 6 months , or to the control group ( PC ) , who maintained only their habitual physical activities . After 6 months , PE returned to their earlier physical activities and strength training was terminated . At baseline , the maximal strength of the trunk extensors ( not significant ) , grip strength and maximal dynamic strength and the shape of the force-time curve of the knee extensors were lower in PE and PC ( P < 0.05 - 0.001 ) than in H. Strength training in PE led to remarkable increases ( P < 0.05 - 0.001 ) in the maximal strength of all muscle groups without changes in the shape of the force-time curve . The increases in muscle strength in PE obtained by strength training were lost to a great degree during the detraining period for the isometric trunk extension ( P < 0.01 ) and flexion ( P < 0.01 ) strength and for the dynamic knee extension strength ( P < 0.05 ) , but not for the grip strength . In PC , trunk extension and flexion strength decreased significantly throughout the study period . At the post-test , all the strength values in both patient groups were much lower than in H. RA is a chronic disease which seems to need continuous physical exercise with sufficient intensity to minimize/prevent the loss of muscle strength and functional capacity OBJECTIVE To evaluate the long-term preventive impact of strength training on muscle performance in older adults . DESIGN A 7-year follow-up on a 1-year r and omized controlled trial comparing the effects of combined resistance training and aerobic training and whole-body vibration training on muscle performance . SETTING University training center . PARTICIPANTS Men and women ( N=83 ; control [ CON ] group , n=27 ; strength-training intervention [ INT ] group , n=56 ) between 60 and 80 years of age . INTERVENTIONS The INT group exercised 3 times weekly during 1 year , performing a combined resistance training and aerobic training program or a whole-body vibration training program . The former training program was design ed according to American College of Sports Medicine guidelines . The whole-body vibration training program included unloaded static and dynamic leg exercises on a vibration platform . The CON group did not participate in any training program . MAIN OUTCOME MEASURES Static strength ( STAT ) , dynamic strength at 60 ° /s ( DYN60 ) and at 240 ° /s ( DYN240 ) , speed of movement at 20 % ( S20 ) . RESULTS From baseline to postintervention , muscle performance did not change in the CON group , except for S20 ( + 6.55%±2.88 % , P<.001 ) . One year of strength training increased ( P≤.001 ) STAT ( + 11.46%±1.86 % ) , DYN60 ( + 6.96%±1.65 % ) , DYN240 ( + 9.25%±1.68 % ) , and S20 ( + 7.73%±2.19 % ) in the INT group . Between baseline and follow-up , muscle performance decreased ( P<.001 ) in both groups . However , STAT and DYN60 showed a significantly lower loss in the INT group ( -8.65%±2.35 % and -7.10%±2.38 % , respectively ) compared with the CON group ( -16.47%±2.69 % and -15.08%±2.27 % , respectively ) . This positive impact might be due to the preservation of the training-induced gains , given the similar annual decline rates in both groups from postintervention to follow-up . Additionally , in trained participants , aging seems to impact velocity-dependent strength and power more compared with basic strength , as the total losses in DYN240 ( CON , -15.93%±2.64 % ; INT , -11.39%±1.95 % ) and S20 ( CON , -14.39%±2.10 % ; INT , -13.16%±1.72 % ) did not differ significantly between the groups . CONCLUSIONS A 1-year strength-training intervention results in an improved muscle performance in older adults 7 years after their enrollment in the intervention . However , an extensive exercise program can not attenuate the age-related decline once the intervention stops The purpose of this study was to evaluate the remaining effects of 12-month intervention of alendronate and exercise on selected risk factors of fragility fractures in 15-month follow-up after withdrawal of intervention among early postmenopausal women . The trial consisted four experimental groups : ( 1 ) 5 mg of alendronate daily + exercise ( Al+Ex+ ) , ( 2 ) 5 mg alendronate daily ( Al+Ex- ) , ( 3 ) placebo + exercise ( Al-Ex+ ) , and ( 4 ) placebo ( Al-Ex- ) . At the follow-up measurements , bone mass and physical fitness of 102 women ( mean age 53.5 + /- 2.5 years ) out of initial 150 subjects could be evaluated .  Alendronate increased bone mass significantly [ mean ; 95 % confidence interval ( CI ) ] during the intervention at the lumbar spine ( 3.9 % ; 2.2 % to 5.7 % ) and femoral neck ( 2.1 % ; 0.9 % to 3.4 % ) . After withdrawal of alendronate , bone loss resumed to the rate comparable to that evident in the placebo group . Despite the declining bone mass , the between-group mean difference ( 3.2 % ; 1.0 % to 5.4 % ) remained at the lumbar spine . However , the benefits at the femoral neck had disappeared 15 months after the withdrawal of alendronate . The 12-month exercise training result ed in significant increases in muscle power , dynamic balance , and aerobic capacity with no benefits on bone mass . Fifteen months later , these performance variables had declined among both the exercisers and nonexercisers . Although the between-group differences were no longer statistically significant , muscle power , dynamic balance , and aerobic capacity of those who exercised still remained above the pretraining levels . In conclusion , 12-month treatment with alendronate prevented  postmenopausal bone loss , and residual effect was seen 15 months after withdrawal of the drug at the lumbar spine . Similarly , exercise improved muscle power , agility , and aerobic capacity during the intervention , but the improvement was lost after the cessation of the exercise program . Based on these results , it was evident that to maintain the benefits of alendronate or exercise , therapy should be continued Aim . The aim of the study was to compare the effects of aerobic exercise training and yoga on the functional capacity , peripheral muscle strength , quality of life ( QOL ) , and fatigue in breast cancer survivors . Material and methods . A total of 52 patients with a diagnosis of breast cancer were included in the study . The patients were r and omly assigned to 2 groups : aerobic exercise ( n = 28 ) and yoga added to aerobic exercise ( n = 24 ) . Both groups participated in submaximal exercise 30 minutes/d , 3 d/wk for 6 weeks . The second group participated in a 1-hour yoga program in addition to aerobic exercise training .  Functional capacity was assessed by the 6-Minute Walk Test ( 6MWT ) . Peripheral muscle strength was evaluated with a h and -held dynamometer . The fatigue severity level was assessed with the Fatigue Severity Scale ( FSS ) . The QOL was determined by the European Organisation for Research and Treatment of Cancer Quality of Life Question naire . Results . There were statistically significant increases in peripheral muscle strength , the 6MWT distance , and the perception of QOL in both groups ( P < .05 ) . Additionally , the group with aerobic exercise and yoga showed marked improvement compared with the aerobic exercise group in fatigue perception ( P < .05 ) . Conclusion . According to the data from this study , aerobic exercise training and yoga improved the functional capacity and QOL of breast cancer patients .  Aerobic exercise programs can be supported by body mind techniques , such as yoga , in the rehabilitation of cancer patients for improving functional recovery and psychosocial wellness This article considers the evidence for effectiveness and timing of rehabilitation  for people with rheumatoid arthritis ( RA ) . The Cochrane Library , DARE , Medline , Embase , CINAHL and AMED were search ed to identify systematic review s and r and omized controlled trials evaluating rehabilitation interventions for people with rheumatoid arthritis . Many trials identified had method ological limitations ( e.g. short follow-up periods , small sample sizes ) . Evidence to date is that symptomatic relief results from thermotherapy , laser therapy , acupuncture and assistive devices . In the short-term , comprehensive occupational therapy ( in established rheumatoid arthritis ) , orthoses , and mind-body approaches can help maintain function . Over at least a one-year period , the following are effective in reducing pain and maintaining function :  patient education and joint protection training using behavioural approaches ; dynamic exercise therapy , h and exercises and hydrotherapy ; and cognitive-behavioural therapy ( in people with poorer psychological status ) . Many trials have recruited people with moderate to severe , established RA and relatively little is known about the long-term effectiveness of early rehabilitation , although this is becoming much more common in practice . Despite the increased availability of guidelines and systematic review s , most conclude there is insufficient evidence for many areas of rheumatology rehabilitation . Further well- design ed clinical trials are needed recruiting people with early disease using patient-centred outcomes
3 ) short-term , water-based aerobic capacity training , which results show limited evidence for a positive effect on functional ability and aerobic capacity .
( 4 ) long-term , l and -based aerobic capacity and muscle strength training , which results show moderate evidence for a positive effect on aerobic capacity and muscle strength .
With respect to safety , no deleterious effects were found in any of the included studies .
Based on the evidence , aerobic capacity training combined with muscle strength training is recommended as routine practice in patients with RA
BACKGROUND An up-to- date overview of the effectiveness and safety of dynamic exercise therapy ( exercise therapy with a sufficient intensity , duration , and frequency to establish improvement in aerobic capacity and /or muscle strength ) is lacking .
OBJECTIVES To assess the effectiveness and safety of short-term ( < three months ) and long-term ( > three months ) dynamic exercise therapy programs ( aerobic capacity and /or muscle strength training ) , either l and or water-based , for people with RA .
To do this we up date d a previous Cochrane review ( van den Ende 1998 ) and made categories for the different forms of dynamic exercise programs .