Effects of an Exercise Program and Cold-Water Immersion Recovery in Patients with Rheumatoid Arthritis (RA): Feasibility Study

Int J Environ Res Public Health. 2023 Jun 15;20(12):6128. doi: 10.3390/ijerph20126128.

Abstract

Rheumatoid Arthritis (RA) patients present is an increased cardiovascular risk (CVR) linked to systemic inflammatory manifestations. A physical activity program with known positive effects on CVR, followed by cryotherapy because of its analgesic and anti-inflammatory effects, may be interesting. However, there are no reports in the literature of such a program. This study aimed to determine the feasibility (acceptability, safety, and effectiveness) of an individualized Intermittent Exercise Program followed by cold-water immersion as a recovery for RA patients. The program was conducted three times per week by eighteen RA patients (one man) with means of age and BMI of 55 (11.9) years and 25.5 (4.7) kg·m-2. Outcomes were assessed before and after nine and seventeen sessions and included evaluation of acceptability by perceived exertion (Borg) and water temperature (VAS) measures at each session; safety by a number of painful and swollen joints (echography); physical function (health assessment questionnaire); general health status (Short Form-36) measures; and effectiveness by arterial stiffness (pulse wave velocity, or PWV) measures. The results showed good acceptability of the program; no patient dropped out of the protocol or even presented difficulties or perceived pain. The HR and PWV values decreased significantly (70.2 ± 8.4 to 66 ± 5.5; p < 0.05 and 8.9 ± 1.2 to 7.0 ± 0.8; p < 0.001) after nine exercise sessions. No aggravation of symptoms has been noted. This program is acceptable, safe, and effective; consider tailoring it for supervised home-based use.

Keywords: aerobic exercise; cardiovascular disease; cryotherapy; rheumatoid arthritis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid* / therapy
  • Exercise
  • Exercise Therapy / methods
  • Feasibility Studies
  • Female
  • Humans
  • Immersion
  • Male
  • Middle Aged
  • Pain
  • Pulse Wave Analysis*
  • Water

Substances

  • Water

Grants and funding

This research was financially supported by a scholarship from the National Council for Scientific and Technological Development (CNPQ), grant number 202287/2014-9. This study was supported by «Fonds européen de développement régional, FEDER», especially «FEDER-FSE Franche-Comté et massif du Jura 2014–2020».