The Effects of Resistance Exercises on the Nitrogen, Phosphorus, and Calcium Metabolism of Patients With Rheumatoid Arthritis 12

Muscle weakness and atrophy are common and disabling manifestations of rheumatoid arthritis for which various types of active exercises are usually prescribed. It is well known that active exercises result in substantial increases in muscle mass and power only when performed repeatedly against resistance with considerable physical effort (1). Although physical activity has been reported to have a protein-anabolic effect and cause calcium retention in normal subjects (2, 3), the metabolic responses to exhaustive physical exertion during active rheumatoid arthritis have not been investigated. These studies were undertaken to deter- mine the effects of heavy resistance exercises on nitrogen, phosphorus, and calcium metabolism in patients experiencing exacerbations of this disease. SUBJECTS 1. M. M., a 42-year-old male, noted symptoms of ar- thritis ten years before admission, characterized by pain in the right hip for six months. Eight, six, and four years before admission, he experienced attacks involving the right shoulder, the left shoulder, and feet, respectively. Four months prior to hospitalization, he developed severe, stiffness and pain in the hands, wrists, elbows, shoulders, hips, knees, and ankles. The fingers, wrists, elbows, and knees became swollen, and nodules appeared over the olecranons. He had had anorexia, marked weakness and fatigue, and had lost 30 pounds.