3 RESEARCH ARTICLES
Sandstad J1, Stensvold D1, Hoff M2,3, Nes BM1, Arbo I1, Bye A4,5,6.
– Rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) are inflammatory diseases which involve increased risk of cardiovascular disease (CVD)
– High intensity interval training (HIIT) is known to be effective in improving cardiovascular health
– The aim of this study was to investigate whether 10 weeks of HIIT at 85-95 % of HRmax would improve important risk factors of CVD in rheumatic patients, and if these patients would tolerate exercise intensities above today’s recommendations.
– Seven women with RA and eleven with adult-JIA, 20-50 years, were recruited to this cross-over study.
– Participants performed HIIT, consisting of 4 × 4 min intervals at 85-95 % of HRmax 2x/wk for 10 wks on spinning bikes.
– Maximal oxygen uptake (VO2max), heart rate recovery, blood pressure, body composition, and blood variables were measured before and after the exercise and control period
– Disease activity was determined and questionnaire data were collected.
(1) HIIT resulted in 12.2 % increase in VO2max and 2.9 % improvement in heart rate recovery
(2) BMI, body fat, and waist circumference decreased 1.2, 1.0, and 1.6 %, respectively, whereas muscle mass increased 0.6 %
(3) A trend toward decreased CRP was detected after HIIT
(4) No changes were detected in disease activity or pain.
(1) Despite rigorous high intensity exercise, no increase was detected in disease activity or pain, indicating that HIIT was well tolerated by these patients
(2) HIIT had positive effects on several CVD risk factors.
(3) In light of this pilot study, HIIT seems like a promising non-pharmacological treatment strategy for patients with RA and adult-JIA.
Benatti FB1, Pedersen BK
– Persistent systemic inflammation, a typical feature of inflammatory rheumatic diseases, is associated with a high cardiovascular risk and predisposes to metabolic disorders and muscle wasting
– These disorders can lead to disability and decreased physical activity, exacerbating inflammation and the development of a network of chronic diseases, thus establishing a ‘vicious cycle’ of chronic inflammation
– During the past two decades, advances in research have shed light on the role of exercise as a therapy for rheumatic diseases
– One of the most important of these advances is the discovery that skeletal muscle communicates with other organs by secreting proteins called myokines
– Some myokines are thought to induce anti-inflammatory responses with each bout of exercise and mediate long-term exercise-induced improvements in cardiovascular risk factors, having an indirect anti-inflammatory effect
– Therefore, contrary to fears that physical activity might aggravate inflammatory pathways, exercise is now believed to be a potential treatment for patients with rheumatic diseases
– We discuss how exercise disrupts the vicious cycle of chronic inflammation directly, after each bout of exercise, and indirectly, by improving co-morbidities and cardiovascular risk factors
– We also discuss the mechanisms by which some myokines have anti-inflammatory functions in inflammatory rheumatic diseases
European League Against Rheumatism
– Exercise transiently suppresses local and systemic inflammation, reinforcing beneficial effects of exercise and need for this to be regular in order to achieve clinical efficacy in rheumatic disease