Arthritis patients show long-term benefits from 3 weeks intensive exercise training directly following hospital discharge


Bulthuis, Y. and Drossaers-Bakker, K.W. and Taal, E. and Rasker, J. and Oostveen, J. and Pad Bosch, P. van 't and Oosterveld, F. and Laar, M. van de (2007) Arthritis patients show long-term benefits from 3 weeks intensive exercise training directly following hospital discharge. Rheumatology, 46 (11). pp. 1712-1717. ISSN 1462-0324

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Abstract:Objective: To examine the efficacy of short-term intensive exercise training (IET) directly following hospital discharge. -
Methods: In the Disabled Arthritis Patients Post-hospitalization Intensive Exercise Rehabilitation (DAPPER) study, patients with rheumatoid arthritis or osteoarthritis were eligible when they needed hospitalization for either a flare-up in disease, elective hip or knee arthroplasty. The intervention group received IET for 3 weeks immediately after discharge; the control group was treated with the usual care (UC). The intensive exercise was provided in a resort. Outcomes were assessed at baseline, after 3, 13, 26 and 52 weeks. Range of motion was measured using the Escola Paulista de Medicina–Range of Motion scale (EPM-ROM), disability was measured using the HAQ and the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR), and for health-related quality of life (HRQoL), the Research and Development 36-Item Health Survey (RAND-36) was used. -
Results: The IET showed a better and faster improvement than UC on all outcome measures except for HRQoL. Up to 52 weeks after baseline, the EPM-ROM and the MACTAR remained favourable in IET compared with UC. At 3 weeks, the MACTAR improved significantly more in the IET compared with the UC: mean difference -5.5 (95% CI -8.4 to -2.2). At 26 weeks, the mean difference remained significant (-5.2; 95% CI -10.0 to -0.34). At 52 weeks, the effect was not significant; however, the mean difference in improvement between the groups can be considered clinically relevant. At 3 weeks, the IET had improved significantly more on the HAQ walking and rising subscales. -
Conclusion: Intensive short-term exercise training of arthritis patients, immediately after hospital discharge results in improved regain of
function. The DAPPER programme has a direct effect, which lasts up to 52 weeks.
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Additional information:Open Access
Copyright:© 2007 Oxford University Press
Faculty of Behavioural, Management and Social sciences (BMS)
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