Land- and water-based exercises in rheumatoid arthritis patients: a series of case reports

Objective. To compare the effects of a 3-month land- and waterbased exercise programme among rheumatoid arthritis (RA) sufferers. Methods. Patients with RA Functional Class I and II (N=10) were randomly assigned to a land-based exercise group (Group L) (N=4), water-based exercise group (Group W) (N=4) or a control group (Group C) (N=2). Testing parameters included swollen joint count (SJC), tender joint count (TJC), erythrocyte sedimentation rate (ESR), haemoglobin (Hb), 50-ft (15.2-m) walk test, grip strength, isokinetic strength of knee extensors and flexors, knee range of motion (ROM) and aerobic capacity. Results. There were individual improvements in most of the physical status parameters tested for the experimental groups (land-based exercise group and water-based exercise group) while the general trend for the control group was that of deterioration. Appropriate land-based exercises did not appear to aggravate disease activity. However, the water-based exercise programme was superior in controlling the disease activity with regards to the tender and swollen joint counts. Conclusion. Both exercise interventions appeared to be beneficial in the treatment of RA. Further research is required comparing various modes of exercises for the treatment of RA, using larger samples and evaluating the long-term effects.