Trainingstherapie bei Rheumatoider Arthritis: Eine systematische Übersicht
| Autor: | G. Küther |
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| Rok vydání: | 2010 |
| Předmět: | |
| Zdroj: | Aktuelle Rheumatologie. 35:364-374 |
| ISSN: | 1438-9940 0341-051X |
| Popis: | INTRODUCTION: In rheumatoid arthritis (RA) pain and reduced joint mobility lead to impairments of muscle strength and endurance. In the long term RA is associated with increased risks of osteoporosis and cardiovascular disease. Physical exercise is considered to be an important cornerstone both in therapy for and prevention of these disease-related problems. However, its clinical relevance, the composition of efficient programmes, and their target population remain obscure. METHODS: Medline and PubMed databases as well as available publications were searched in this systematic review by using the key words “rheumatoid arthritis, dynamic exercise, aerobic exercise”. RESULTS: No immunological reactions in response to exercise are described with relevance to the clinical course of the disease. 12 randomised controlled studies were identified with sufficient intensity and duration (>6 weeks) of dynamic exercises. All reviews and all studies with observation periods up to 5 years agree that dynamic exercises are safe in adult as well as juvenile RA patients with mild to moderate impairment and stable disease. There is good evidence for an improvement of aerobic capacity, muscle strength, mobility and a reduced decrease of bone mineral density by intensive supervised training programmes in adult, but not juvenile patients. Some evidence exists that home-based programmes of similar intensity may work as well, provided that patients are correctly instructed at the onset and controlled at regular intervals. Conflicting evidence exists considering the clinical consequences of training programmes to functional capacity and health-related quality of life, no data are available on the prevention of cardiovascular complications. CONCLUSION: The positive effects support a wider use of physical exercise programmes in adult RA patients with mild impairment and stable disease, both as therapy and prevention. However, the occurrence of adverse long-term effects on large, weight-bearing joints cannot be completely excluded with the available data. High exercise loads should be avoided in patients with joint damage. The role of physical exercise in juvenile RA patients and patients with severe impairments remains unsettled. In particular, in acute flares and in elderly, severely deconditioned patients conventional physiotherapy will remain an essential part at least of initial treatment. |
| Databáze: | OpenAIRE |
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