Are persons with rheumatoid arthritis deconditioned? A review of physical activity and aerobic capacity

Tjerk Munsterman,Tim Takken,Harriet Wittink

doi:10.1186/1471-2474-13-202

Abstract

BackgroundAlthough the general assumption is that patients with rheumatoid arthritis (RA) have decreased levels of physical activity, no review has addressed whether this assumption is correct.MethodsOur objective was to systematically review the literature for physical activity levels and aerobic capacity (VO2max). in patients with (RA), compared to healthy controls and a reference population. Studies investigating physical activity, energy expenditure or aerobic capacity in patients with RA were included. Twelve studies met our inclusion criteria.ResultsIn one study that used doubly labeled water, the gold standard measure, physical activity energy expenditure of patients with RA was significantly decreased. Five studies examined aerobic capacity. Contradictory evidence was found that patients with RA have lower VO2max than controls, but when compared to normative values, patients scored below the 10th percentile. In general, it appears that patients with RA spend more time in light and moderate activities and less in vigorous activities than controls.ConclusionPatients with RA appear to have significantly decreased energy expenditure, very low aerobic capacity compared to normative values and spend less time in vigorous activities than controls.

Highlights

The general assumption is that patients with rheumatoid arthritis (RA) have decreased levels of physical activity, no review has addressed whether this assumption is correct
According to the recent EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis [3], RA should be regarded as a condition associated with higher risk for cardiovascular disease (CVD)
According to the gold standard persons with RA were less active compared to healthy subjects

Summary

Introduction

The general assumption is that patients with rheumatoid arthritis (RA) have decreased levels of physical activity, no review has addressed whether this assumption is correct. According to the recent EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis [3], RA should be regarded as a condition associated with higher risk for cardiovascular disease (CVD). Recent research shows that a moderately high or high aerobic capacity, but not high physical activity reduces metabolic syndrome and CVD and DM II risk even in obese persons [7]. A recent systematic review on physical activity in RA concluded that methodological considerations within the reviewed studies prohibited definitive conclusions on the PA levels in this population [16]. The aim of this review did not include gathering evidence on aerobic capacity

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Conclusion