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Effectiveness of Aquatic Exercises in Women With Rheumatoid Arthritis: A Randomized, Controlled, 16-Week Intervention—The HydRA Trial

Siqueira, Usmary S. PhD; Orsini Valente, Luciana G. MD; de Mello, Marco Túlio PhD; Szejnfeld, Vera L. MD, PhD; Pinheiro, Marcelo M. MD, PhD

American Journal of Physical Medicine & Rehabilitation: March 2017 - Volume 96 - Issue 3 - p 167–175
doi: 10.1097/PHM.0000000000000564
Original Research Articles

Objective: The purpose of this study was to compare the effectiveness of land-based (LB) and water-based (WB) aerobic exercises in women with rheumatoid arthritis (RA).

Design: A total of 133 women with RA were included in this randomized, blinded, prospective, 16-week controlled trial. The subjects were randomized into 3 groups: WB (n = 33), LB (n = 33), and control (n = 34). Muscle strength (MS) was measured using an isokinetic dynamometer. Disease activity (DAS-28) and functional ability (health assessment questionnaire) were measured by an expert rheumatologist. Total body densitometry was used to assess body composition. The intervention was performed 3 times per week, and all groups were evaluated at baseline and after 8 and 16 weeks. Compliance, concomitant medications, and adverse events were recorded. The data were analyzed by intention to treat. P < 0.05 was set as significant.

Results: Of the 133 patients recruited, 100 were randomized and 82 completed the study. In the first evaluation, the 3 groups were matched to age, body composition, functional capacity, MS, and concomitant medications. After 16 weeks, there were no significant changes of knee MS neither body composition among the groups. However, there was a significant improvement in disease activity and functional ability in the WB after 8 and 16 weeks.

Conclusion: Aquatic exercises provided significant improvement in disease activity, pain, and functional capacity.

From the Rheumatology Division (USS, LGOV, VLS, MMP) and Department of Sport Medicine, Psychobiology and Sleep Medicine (MTM), Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/EPM).

All correspondence and requests for reprints should be addressed to: Marcelo M. Pinheiro, MD, PhD, Rua Leandro Dupré, 204, Conjunto 74, Vila Clementino 04025-010, São Paulo, SP, Brazil.

The HydRA trial had financial support from the Rheumatology Division and Department of Sport Medicine of the Federal University of Sao Paulo, Brazil. This work was not supported by any commercial sources; nor did any of the authors have any competing financial interests.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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