For people with extensive damage in large joints from Rheumatoid Arthritis, high-intensity, weight-bearing exercise apparently accelerates the progression of joint damage, Dutch researchers suggest.

However, intensive exercise appears to be safe for arthritis patients with little or no joint damage.

Previous studies have shown that exercise programs to improve muscle strength and aerobic capacity are beneficial for people with Rheumatoid Arthritis.

However, one study did uncover a trend toward more damage within large joints after high-intensity exercise.

In the current report, published in the journal Arthritis Care and Research, Dr. Marten Munneke, from Leiden University Medical Center, and his colleagues investigated outcomes after two years for 277 participants in the Rheumatoid Arthritis Patients in Training (RAPIT) study - 140 assigned to usual care, and 137 to the exercise program.

The amount of joint damage at the start of the study was a significant factor in effects of exercise, the investigators found.

For the 218 patients with a low initial joint-damage score, the exercise program had no effect on joint damage. For the 59 others with higher initial scores, there was a faster rate of damage in the exercise group.

Shoulder and ankle joints were particularly affected.

“Rheumatologists and physiotherapists should advise patients with rheumatoid arthritis to be cautious with excessive loading of extensively damaged joints,” Munneke’s group advises. They recommend that individualized exercise program should be designed for people with already extensively damaged large joints.

SOURCE: Arthritis Care and Research, June 15, 2005.