Document Detail

Arthritis patients show long-term benefits from 3 weeks intensive exercise training directly following hospital discharge.
MedLine Citation:
PMID:  17956917     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine the efficacy of short-term intensive exercise training (IET) directly following hospital discharge. METHODS: In the Disabled Arthritis Patients Post-hospitalization Intensive Exercise Rehabilitation (DAPPER) study, patients with rheumatoid arthritis or osteoarthritis were eligible when they needed hospitalization for either a flare-up in disease, elective hip or knee arthroplasty. The intervention group received IET for 3 weeks immediately after discharge; the control group was treated with the usual care (UC). The intensive exercise was provided in a resort. Outcomes were assessed at baseline, after 3, 13, 26 and 52 weeks. Range of motion was measured using the Escola Paulista de Medicina-Range of Motion scale (EPM-ROM), disability was measured using the HAQ and the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR), and for health-related quality of life (HRQoL), the Research and Development 36-Item Health Survey (RAND-36) was used. RESULTS: The IET showed a better and faster improvement than UC on all outcome measures except for HRQoL. Up to 52 weeks after baseline, the EPM-ROM and the MACTAR remained favourable in IET compared with UC. At 3 weeks, the MACTAR improved significantly more in the IET compared with the UC: mean difference -5.5 (95% CI -8.4 to -2.2). At 26 weeks, the mean difference remained significant (-5.2; 95% CI -10.0 to -0.34). At 52 weeks, the effect was not significant; however, the mean difference in improvement between the groups can be considered clinically relevant. At 3 weeks, the IET had improved significantly more on the HAQ walking and rising subscales. CONCLUSION: Intensive short-term exercise training of arthritis patients, immediately after hospital discharge results in improved regain of function. The DAPPER programme has a direct effect, which lasts up to 52 weeks.
Y Bulthuis; K W Drossaers-Bakker; E Taal; J Rasker; J Oostveen; P van't Pad Bosch; F Oosterveld; M van de Laar
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  46     ISSN:  1462-0324     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-24     Completed Date:  2007-12-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1712-7     Citation Subset:  AIM; IM    
Institute for Behavioral Research, University of Twente, Enschede, The Netherlands.
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MeSH Terms
Aged, 80 and over
Arthritis / physiopathology,  rehabilitation*,  surgery
Arthritis, Rheumatoid / physiopathology,  rehabilitation
Arthroplasty, Replacement, Hip / rehabilitation
Arthroplasty, Replacement, Knee / rehabilitation
Disability Evaluation
Exercise Therapy / methods*
Health Status Indicators
Middle Aged
Osteoarthritis, Hip / physiopathology,  rehabilitation,  surgery
Osteoarthritis, Knee / physiopathology,  rehabilitation,  surgery
Patient Discharge
Quality of Life
Range of Motion, Articular
Treatment Outcome

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