Muscle function in rheumatoid arthritis. Assessment and training

Abstract

The conclusions can be summarized as follows: experienced problems of muscle function were reported in about 80% of RA and OA patients for whom there was involvement of large joints of the lower extremities; RA and OA patients did not differ as to experienced problems of muscle strength, endurance and balance/coordination; problems of muscle function were correlated with functional tests of muscle strength but not with those of endurance and balance/coordination; problems of muscle strength were found to correlate with LE-ADL, whereas problems of endurance and balance/coordination were not found to correlate with the latter; the translated and slightly modified version of the HAQ questionnaire appeared to possess a high degree of reliability and validity in assessing disability in patients with RA under Swedish conditions; a quantitative battery of tests for the evaluation of standing balance on a computerized force platform was found to be satisfactorily reliable and to correlate in healthy subjects with most of the functional tests employed; in healthy subjects, standing balance appeared to be related not only to age but also to sex, males and older age groups showing greater postural sway than females and persons of younger age groups; compared with healthy subjects, RA subjects showed significantly greater postural sway, differences being greatest for those tests representing a relatively high level of difficulty; dynamic training for six weeks appeared to provide RA patients with a greater increase in physical capacity of the lower extremities than did static training, the gains thus obtained still being present after an additional three-month period; the effectiveness of the dynamic training programs did not vary with the degree of supervision of training by a physiotherapist, i.e. of 12 visits or 4 being made at the health care centre; despite the intensity of the dynamic training-program employed with RA patients, no increase in pain experience or disease activity was found during the training-period; during short-term high-intensity training a significant increase in circulating beta-EP was found between the 3rd and 6th weeks of training, no increase in CRF and beta-LPH being present; following a long-term low-intensity training period, a significant increase of CRF and beta-LPH was found, no similar increase being noted for beta-EP.