Effectiveness of Water Exercises on Isokinetic Muscle Strength
Condition: Rheumatoid Arthritis
MeSH terms: Arthritis; Arthritis, Rheumatoid
Study type: Interventional
Phase: Phase 3

Summary: 
      The interest in studying the impact of aquatic exercise on muscle strength of patients with
      rheumatoid arthritis came after publication of several studies that pointed to the potential
      benefit of exercise on the natural history of the disease, including reduction of pain,
      better immune response as well as aerobic fitness and functional capacity and increase muscle
      strength, endurance and quality of life.

      In general, the aquatic exercises are indicated for patients with chronic joint diseases,
      since the aquatic environment seems to be more secure for this population due to the
      reduction of joint loading, as well as gain range of motion.

      However, there are some difficulties to show the real and consistent beneficial effect of
      physical activity in these patients, such as the small number of randomized controlled
      clinical trials, short intervention period (4-8 weeks), lack of details of the exercise
      protocols used, methodological problems (heterogeneous measures to evaluate the outcome,
      change of medication). Moreover, no study evaluated the disease activity, according to the
      tool most used clinically worldwide, the DAS28.

      It is known that aquatic exercises without impact in healthy subjects are sufficient to gain
      muscle strength. Nonetheless, in people with joint limitation the benefits from these same
      exercises to gain muscle strength is not known.

      To date, no studies addressing the effect of aquatic exercise on muscle strength and disease
      activity in patients with rheumatoid arthritis. In addition, there is the need to obtain a
      standardized protocol for prescribing of aquatic exercises. The choice of lower-limb strength
      was based on its relevance to the acceleration and deceleration during the march, as well as
      to perform activities of daily living, leisure and professional in these individuals.

      Thus, this study aims at:

        1. Exercises performed in the aquatic environment and without the concomitant use of
           overhead equipment are sufficient to promote gain muscle strength in the lower limb?

        2. What is the isolated effect of water resistance on muscle strength? Could it work as an
           impact that is used in exercises done on the land?
    

Detailed description: 
      The investigators objectives are:

        -  To compare the peak torque of flexor and extensor of the knee between land and water
           exercises in women with rheumatoid arthritis. This is a randomized controlled clinical
           trial with 16 weeks of length;

        -  To verify the changes of disease activity, functional capacity and body composition
           measurements before and after the intervention
    

Intervention name(s): Land exercises; Water exercises
Intervention type(s): Procedure; Procedure
Intervention description(s): 3 times a week. 50 minutes in every session. Performed by educational professor; 3 times a week. 50 minutes in every session. Performed by educational professor
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Rheumatoid arthritis; Muscle strength; Body composition; Physical activity; Water exercises; Hydrotherapy; Randomized controlled clinical trial