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 .
Cost-utility and cost-effectiveness analyses of a long-term, high-intensity exercise program compared with conventional physical therapy in patients with rheumatoid arthritis.
OBJECTIVE To estimate the cost utility and cost effectiveness of long-term , high-intensity exercise classes compared with usual care in rheumatoid arthritis ( RA ) patients . METHODS RA patients ( n = 300 ) were r and omly assigned to either exercise classes or UC ; followup lasted for 2 years . Outcome measures were quality -adjusted life years ( QALYs ) according to the EuroQol ( EQ-5D ) , Short Form 6D ( SF-6D ) , and a transformed visual analog scale ( VAS ) rating personal health ; functional ability according to the Health Assessment Question naire ( HAQ ) and McMaster Toronto Arthritis Patient Preference Interview ( MACTAR ) ; and societal costs . RESULTS QALYs in both r and omization groups were similar according to the EQ-5D and SF-6D , but were in favor of usual care according to the VAS ( annual difference 0.037 QALY ; 95 % confidence interval [ 95 % CI ] 0.002 , 0.069 ) . Functional ability was similar according to the HAQ , but in favor of the exercise classes according to the MACTAR ( annual difference 2.9 QALY ; 95 % CI 0.9 , 4.9 ) . Annual medical costs of the exercise program were estimated at 780 per participating patient ( 1 approximately $ 1.05 ) . The increase per patient in total medical costs of physical therapy was estimated at 430 ( 95 % CI 318 , 577 ) , and the increase in total societal costs at 602 ( 95 % CI -490 , 1,664 ) . For societal willingness-to-pay equal to 50,000 per QALY , usual care had better cost utility than exercise classes , and significantly so according to the VAS . CONCLUSION From a societal perspective and without taking possible preventive health effects into account , long-term , high-intensity exercise classes provide insufficient improvement in the valuation of health to justify the additional costs
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 .