Long-term supervised exercise works better than usual care in RA

For people with rheumatoid arthritis (RA) and severe functional limitations, undergoing supervised exercise therapy for more than 52 weeks results in better outcomes compared with usual care, as reported in a study.

For the study, researchers enrolled 217 participants (mean age 58.8 years, 90 percent women) with RA and severe functional limitations. These participants were randomly assigned to undergo the study intervention or usual care for 52 weeks. The intervention consisted of individualized goal setting, active exercises, education, and self-management.

The change in the Patient-Specific Complaints activity ranked 1 (PSC1, 0–10) was evaluated at 52 weeks and designated as the primary endpoint. Secondary endpoints included the PSC activities ranked 2 and 3 (PSC2, PSC3), Health Assessment Questionnaire-Disability Index (HAQ-DI), Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL), 6-minute walk test (6MWT), Patient Reported Outcome Measurement Information System Physical Function-10 (PROMIS PF-10), and the Short Form-36 Physical and Mental Component Summary Scales (SF-36 PCS and MCS). Adverse events (AEs) were also recorded.

The intention-to-treat population included 104 participants in the intervention arm and 98 in the usual-care arm. At 52 weeks, the intervention arm achieved significantly larger improvements in the PSC1 (mean difference, −1.7, 95 percent confidence interval [CI], −2.4 to –1.0).

Likewise, the intervention led to greater improvements in all secondary outcomes compared with usual care (PSC2, −1.8, 95 percent CI, −2.4, –1.1; PSC3, −1.7, 95 percent CI, −2.4 to −1.0; PROMIS PF-10, 3.09, 95 percent CI, 1.80–4.38; HAQ-DI, −0.17, 95 percent CI, −0.29 to –0.06; RAQoL, −2.03, 95 percent CI, −3.39 to –0.69; SF-36 PCS, 3.83, 95 percent CI, 1.49, 6.17; 6MWT, 56 m, 95 percent CI, 38–75), with the exception of the SF-36 MCS.

In terms of safety, one mild, transient AE occurred in the intervention group.