National Advisory Unit on Rehabilitation in Rheumatology

Maastricht, Netherlands

National Advisory Unit on Rehabilitation in Rheumatology

Maastricht, Netherlands
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Sveaas S.H.,National Advisory Unit on Rehabilitation in Rheumatology | Sveaas S.H.,University of Oslo | Smedslund G.,National Advisory Unit on Rehabilitation in Rheumatology | Smedslund G.,Norwegian Institute of Public Health | And 4 more authors.
British Journal of Sports Medicine | Year: 2017

Objective To investigate the effects of cardiorespiratory and strength exercises on disease activity for patients with inflammatory rheumatic diseases (IRDs). Design A systematic review with meta-analysis registered at PROSPERO (CRD42015020004). Participants Patients with IRDs. Data sources The databases MEDLINE, AMED, Embase and CINAHL were searched from inception up to April 2016. Eligibility criteria for selecting studies Trials were included if they were randomised controlled trials of adults with IRDs, comparing the effect of cardiorespiratory and strength exercises with usual care on disease activity and followed the American College of Sports Medicine's exercise recommendations. The primary outcome was disease activity in terms of inflammation, joint damage and symptoms. Data synthesis Data were pooled in a random-effect model for all outcomes, and standardised mean differences (SMDs) were calculated. The quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation approach. Results Twenty-six trials with a total of 1286 participants were included. There was high to moderate quality evidence, for a small beneficial effect on disease activity scores (0.19 (95% CI 0.05 to 0.33), p<0.01) and joint damage (SMD 0.27 (95% CI 0.07 to 0.46), p<0.01). Furthermore, moderate quality evidence for a small beneficial effect on erythrocyte sedimentation rate (SMD 0.20 (95% CI 0.0 to 0.39), p=0.04) and for no effect on C reactive protein (SMD -0.14 (95% CI -0.37 to 0.08), p=0.21). Beneficial effects were also seen for symptoms. Conclusions The results of this review suggest beneficial effects of exercises on inflammation, joint damage and symptoms in patients with IRDs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.


Navarro-compan V.,Leiden University | Navarro-compan V.,Hospital Universitario La Paz | Landewe R.,University of Amsterdam | Landewe R.,Atrium Medical | And 11 more authors.
Rheumatology (United Kingdom) | Year: 2014

Objective. The aim of this study was to assess if any of the different types of radiographic damage [true joint space narrowing (JSN), (sub)luxation and erosions] are preferentially related to disability in patients with RA.Methods. Longitudinal data from 167 RA patients from the European Research on Incapacitating Diseases and Social Support study over 10 years were analysed to investigate the relationship between the three types of radiographic damage and disability [grip strength, HAQ and the dexterity scale in the Arthritis Impact Measurement Scales (AIMS)]. A longitudinal analysis including separate models per type of damage and joint group and combined models including all information was conducted.Results. All types of damage were inversely related to grip strength in the analysis of separate models, but only true JSN independently remained statistically significant in the combined analysis [β = -0.087 (95% CI -0.151, -0.022)]. Neither JSN, (sub)luxation nor erosions were associated with HAQ score, while erosions were associated with AIMS dexterity only in the analysis of separate models. After stratifying for hand joint group, erosions at MCP joints [β = -0.288 (95% CI -0.556, -0.019)] and true JSN at the wrist [β = -0.132 (95% CI -0.234, -0.030)] were significantly related to grip strength. Erosions at the PIP [β = 0.017 (95% CI 0.005, 0.028)] and MCP joints [β = 0.114 (95% CI 0.010, 0.217)] was the only type of damage associated with HAQ and AIMS dexterity, respectively.Conclusion. All types of radiographically visible joint damage interfere with important aspects of physical functions. True JSN is most closely related to hand function. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

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