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Radiologically Observed Progression of Joint Destruction and Its Relationship With Demographic Factors, Disease Severity, and Exercise Frequency in Patients With Rheumatoid Arthritis

CH Stenström, BSc, RPT, is Physical Therapist, Kullbergska Hospital, Katrineholm, Sweden, and a doctoral student at the Department of Rehabilitation and Physical Medicine, Karolinska Institute, PO Box 60500, S-10401 Stockholm, Sweden.
This research was completed in partial fulfillment of the requirements for Ms Stenström's doctoral degree.

Background and Purpose. The aim of the study was to investigate the 4-year progression of radiologically observed joint destruction and its relationship with demographic factors, disease severity, and exercise frequency in patients with rheumatoid arthritis. Subjects. The subjects were 69 patients (56 women, 13 men; mean age=54 years; mean duration of symptoms=14 years) with American Rheumatism Association functional class II rheumatoid arthritis. Methods. The patients were assessed with a modified Larsen's radiological index (maximum score=220), laboratory tests, Ritchie's articular index, and questionnaires regarding their self-selected low-intensive–intensive dynamic exercise frequency. Results. The Larsen's radiological index was initially 67 (SD=42.4) and progressed to 82 (SD=42.3) during the 4-year study period. Four-year radiological progression correlated with mean erythrocyte sedimentation rate (30 mm/h, SD=12.6), but not with self-selected exercise frequency ( once a week or twice a week) or with any other variables investigated. Conclusion and Discussion. The radiologically observed progression of joint destruction seemed rather slow in this group of nonhospitalized, functionally independent patients with rheumatoid arthritis, and it was only related with mean erythrocyte sedimentation rate. Self-selected exercise frequency did not seem to be related with radiologically observed progression of joint destruction.

Key Words: Disease severity • Exercise frequency • Radiology • Rheumatoid arthritis

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