High-intensity exercise for maintained health-enhancing physical activity in patients with rheumatoid arthritis: a randomised controlled trial

Objective To explore the long-term effects of a high-intensity exercise intervention on physical activity (PA) in patients with rheumatoid arthritis (RA) Methods Eighty-seven patients (84% female), mean age 48 (SD 9.66) years, with a mean disease activity of 2.0 (SD 1.04) (Disease Activity Score based on 28 joints) were included and randomly assigned to an intervention group (IG) comprising 12-week supervised high-intensity interval training (HIIT) on bicycles ergometric, and strength exercise, or to a control group (CG) receiving counselling on the general recommendations for PA and being provided with a home exercise programme. PA was assessed by both accelerometer and self-reports at baseline, at 6 months and at 12 months from baseline. Results The majority of the patients (86%) in the exercise group adhered to ≥80% of the 12-week exercise protocol. A significant intervention effect was found for accelerometry-derived ambulatory vigorous PA (4.7 min/day 95% CI 0.82 to 8.51, p=0.0177) at 12-month follow-up, in favour of the IG. The patients in the IG had a higher OR for self-reported PA, including bicycling (6.6 95% CI 1.29 to 34.37, p=0.0239) at 6-month follow-up, and strength exercise at 12-month follow-up (23.1 95% CI 1.64 to 327.13, p=0.0204) compared with the CG. No effects were found for sedentary time and ambulatory moderate PA at 6-month and 12-month follow-up. Conclusions The findings of this randomised controlled multicentre study show that patients with RA who participated in 12 weeks of supervised HIIT and strength exercise increased and maintained long-term health-enhancing PA to a greater extent than patients in the CG.