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 .
Slowing of bone loss in patients with rheumatoid arthritis by long-term high-intensity exercise: results of a randomized, controlled trial.
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
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 .