The effect of progressive resistance training in rheumatoid arthritis. Increased strength without changes in energy balance or body composition

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Abstract
Objective. To demonstrate the feasibility of high‐intensity progressive resistance training in rheumatoid arthritis (RA) patients compared with healthy control subjects. Methods. Eight subjects with RA, 8 healthy young subjects, and 8 healthy elderly subjects underwent 12 weeks of high‐intensity progressive resistance training, while 6 elderly subjects performed warm‐up exercises only. Fitness, body composition, energy expenditure, function, disease activity, pain, and fatigue were measured at baseline and followup. Results. All 3 training groups demonstrated similar improvements in strength compared with the change among control subjects (RA group 57% [P < 0.0005], young exercise group 44% [P < 0.01], elderly exercise group 36% [P < 0.05]). Subjects with RA had no change in the number of painful or swollen joints but had significant reductions in self‐reported pain score (21% [P < 0.05]) and fatigue score (38% [P = 0.06]), improved 50‐foot walking times (mean ± SD 10.4 ± 2.2 seconds versus 8.3 ± 1.5 seconds [P < 0.005]), and improved balance and gait scores (48.9 ± 3.8 versus 50.4 ± 2.0 [P = 0.07]). Conclusion. High‐intensity strength training is feasible and safe in selected patients with well‐controlled RA and leads to significant improvements in strength, pain, and fatigue without exacerbating disease activity or joint pain.