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Progressive resistance training (PRT) improves rheumatoid arthritis outcomes: A district general hospital (DGH) model
Author(s) -
Morsley Klara,
Berntzen Berna,
Erwood Lisa,
Bellerby Toby,
Williamson Lyn
Publication year - 2018
Publication title -
musculoskeletal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.628
H-Index - 28
eISSN - 1557-0681
pISSN - 1478-2189
DOI - 10.1002/msc.1193
Subject(s) - medicine , rheumatoid arthritis , physical therapy , mood , hospital anxiety and depression scale , depression (economics) , grip strength , visual analogue scale , anxiety , waist , arthritis , body mass index , psychiatry , economics , macroeconomics
Objective Rheumatoid cachexia is common in rheumatoid arthritis (RA) patients and develops soon after diagnosis, despite adequate drug therapy. It is associated with multiple adverse effects on body composition, function and mortality. Progressive resistance training (PRT) improves these outcomes but is not widely prescribed outside of a research setting. The aim of the present study was to explore the practicality and effectiveness of providing PRT to patients in a district general hospital within the constraints of existing resources. Methods Patients attending a rheumatology clinic were invited to participate in a weekly PRT class for 6 weeks, supervised by a physiotherapist. Outcome measures included: body composition measures (waist and hip circumference, weight, percentage body fat); functional measures (grip strength, 60‐s sit‐to‐stand test, single leg stance, Health Assessment Questionnaire); mood; fatigue and disease activity measures (sleep scale, hospital anxiety and depression scale, Functional Assessment of Chronic Illness Therapy, pain visual analogue scale). These were measured at baseline and at 6 weeks. Results A total of 83 patients completed the programme (60% female, mean age 51.2 years), of whom 34.9% had early RA. Improvements were seen in multiple measures inpatients with early RA and with established inflammatory arthritis, and were not affected by age or gender. Conclusions Patients with early and established inflammatory arthritis alike benefited from a 6‐week PRT programme provided within a National Health Service setting. Although further work is needed to look at long‐term effects, we suggest that this intervention should be more widely available.