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The effects of aerobic and resistance exercise on markers of large joint health in stable rheumatoid arthritis patients: a pilot study

Research output: Contribution to journalArticlepeer-review

  • Rebecca-Jane Law
  • Dr Zoe Saynor
  • Julia Gabbitas
  • Jeremy Jones
  • Alexandra Kraus
  • Anne Breslin
  • Peter J. Maddison
  • Jeanette M. Thom
Objective - Exercise is beneficial for people with rheumatoid arthritis (RA). However, patients and health professionals have expressed concern about the possible detrimental effects of exercise on joint health. The present study investigated the acute and chronic effects of high-intensity, low-impact aerobic and resistance exercise on markers of large joint health in RA.

Methods - Eight RA patients and eight healthy, matched control (CTL) participants performed 30 minutes’ high-intensity, low-impact aerobic and lower-body resistance exercise, one week apart. Primary outcome measures assessing joint health were serum cartilage oligomeric matrix protein (sCOMP) and knee joint synovial inflammation (Doppler ultrasound colour fraction; CF). These measures were taken at baseline, immediately after and 0.5, one, two, six and 24 hours post-exercise. In a separate study, nine RA patients completed eight weeks of progressive exercise training. The same outcome measures were reassessed at baseline, and at one hour post-exercise of training weeks 0, 1, 4 and 8.

Results - RA patients showed higher overall sCOMP [RA: 1,347 ± 421, CTL: 1,189 ± 562 ng/mL; p < 0.05; effect size (ES) = 0.32] and CF when scanned longitudinally (RA: 0.489 ± 0.30 × 10–3, CTL: 0.101 ± 0.13 × 10–3; p < 0.01; ES = 1.73) and transversely (RA: 0.938 ± 0.69 × 10–3, CTL: 0.199 ± 0.36 × 10–3; p < 0.01; ES = 1.33) than CTL. However, no acute effects on joint health were observed post-exercise. Similarly, no chronic effects were observed over eight weeks of combined aerobic and resistance training in RA, with positive effects on physical fitness and function.

Conclusions - RA patients on stable treatment with low disease activity were able to perform an individually prescribed high-intensity, low-impact aerobic and resistance exercise without changes in markers of large joint health.
Original languageEnglish
Pages (from-to)222-235
JournalMusculoskeletal Care
Issue number4
Early online date12 May 2015
Publication statusPublished - Dec 2015


  • The effects of aerobic and resistance exercise

    Rights statement: This is the peer reviewed version of the following article: Law, R.-J., Saynor, Z. L., Gabbitas, J., Jones, J., Kraus, A., Breslin, A., Maddison, P. J., and Thom, J. M. (2015), The Effects of Aerobic and Resistance Exercise on Markers of Large Joint Health in Stable Rheumatoid Arthritis Patients: A Pilot Study. Musculoskelet. Care, doi: 10.1002/msc.1103., which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

    Accepted author manuscript (Post-print), 435 KB, PDF document

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