Comparable effect of partly supervised and self-administered exercise programme in early rheumatoid arthritis--a randomised, controlled trial.

INTRODUCTION There is a need to establish a framework and exercise level for patients with early rheumatoid arthritis (RA). The aim of this study was to compare the effect of a partly supervised and a self-administered exercise programme for patients with early RA. METHODS A total of 51 patients with early (≤ 5 years) RA were randomised to either a six-week supervised, progressive, high-intensity exercise programme followed by a six-week self-administered exercise programme or a 12-week self-administered exercise programme. RESULTS A total of 36 patients completed the study. Following the 12 weeks of exercises, patients in the two groups had improved both their muscle strength and their physical fitness. There was a significant difference in Disease Activity Score in 28 joints calculated with C-reactive protein between the two exercise groups, but no significant differences in physical fitness, pain perception, Health Assessment Questionnaire, Short Form 36 health survey questionnaire, Fear-Avoidance Beliefs Questionnaire, or in muscle strength, except from a significant difference in trunk extensors. The dropout was 40% in the supervised group versus 20% in the self-administered group. CONCLUSION A progressive, high-intensity exercise programme is feasible for patients with early RA, although we observed an elevated number of dropouts for reasons not related to the intervention. The partly supervised exercise programme with follow-up after 12 weeks does not seem to be more effective than the self-administered exercise programme. FUNDING none. TRIAL REGISTRATION The trial was registered with www.clinicaltrials.gov (NCT01553305).