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Background: Little is known about the effects of exercise on radiological joint damage of the hands and feet in patients with rheumatoid arthritis.

Research question/s: Does long term high intensity weight bearing exercise cause radiological damage of the joints of the hands and feet in patients with rheumatoid arthritis (RA)?

Subjects: 281 subjects with RA according to the American College of Rheumatology (ACR) criteria.

Experimental procedure: All of the subject were part of a 2-year randomised controlled trial in which the effects of usual care physical therapy (CON = 145) were compared with a high intensity weight bearing exercise programme (EX = 136). The rate of radiological joint damage (Larsen score: 0–200, number of damaged joints) of the hands and feet, disease activity (DAS4 score), drug use, physical capacity, bone mineral density, and attendance rate was assessed at baseline 6, 12, 24, 18, and 24 months).

Measures of outcome: Potential determinants of outcome were defined: disease activity, use of drugs, change in physical capacity and in bone mineral density, and attendance rate at exercise sessions.

Main finding/s:

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  • Subjects in the EX group developed significantly less radiological damage than the subjects in the CON group, and this difference in rate of increase of damage is more pronounced in the joints of the feet than in the hands

  • The rate of damage was independently associated with less disease activity, less frequent use of glucocorticoids, and with an improvement in …

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