High-Intensity Exercise and Physical Activity Maintenance in Rheumatoid Arthritis
Key Takeaways
- The supervised program was associated with more accelerometer-measured ambulatory vigorous physical activity at 12 months than the comparison approach.
- Self-reported bicycling was more likely at 6 months and self-reported strength exercise was more likely at 12 months, while sedentary time and ambulatory moderate physical activity did not differ.
The supervised strategy combined bicycle-based intervals and strength work, while the comparison group received counseling and home exercise alone.
The multicenter randomized controlled trial enrolled 87 patients with rheumatoid arthritis, and 84% of participants were female. Mean age was 48 years (SD 9.66), and mean disease activity was 2.0 (SD 1.04) on the Disease Activity Score based on 28 joints. Participants in the intervention group completed a 12-week supervised bicycle ergometer high-intensity interval training program together with strength exercise. The comparator group received counseling on general physical activity recommendations and a home exercise program.
Physical activity was assessed by accelerometer and self-report at baseline, 6 months, and 12 months. Accelerometry addressed ambulatory intensity, while self-report covered specific activities such as bicycling and strength exercise.
At 12 months, ambulatory vigorous physical activity favored the intervention group, with a 95% CI of 0.82 to 8.51 and p=0.0177. Self-reported bicycling also favored the intervention group at 6 months, with an OR of 6.6 (95% CI 1.29 to 34.37; p=0.0239). Self-reported strength exercise remained more likely at 12 months, with an OR of 23.1 (95% CI 1.64 to 327.13; p=0.0204). Sedentary time and ambulatory moderate physical activity did not differ at 6 and 12 months. Overall, the gains were concentrated in selected activity domains.
Adherence to the supervised program was high, with 86% of the exercise group completing at least 80% of the 12-week protocol.