Home exercise in rheumatoid arthritis functional class II: goal setting versus pain attention

To evaluate the effects of a 12-week home exercise and cognitive treatment program in functionally independent patients with rheumatoid arthritis.

Forty-two patients were assessed with the Arthritis Self-efficacy Scale, the Stanford Health Assessment Questionnaire, the Ritchie articular index, measurement of joint mobility, and registration of capacity and pain in functional tasks. The patients were then randomized to either a "goal-setting" subgroup, in which individual goals for the exercise were set and exercise encouraged despite pain, or to a "pain attention" subgroup, where advice to decrease exercise load in case of pain was given. All patients used the same home exercise program aiming at improved range of motion, muscle function and aerobic capacity.

After the intervention period, exercise had conferred better self-efficacy for "other symptoms," increased capacity in most functional tasks, decreased activity induced pain, lowered Ritchie index, and increased joint mobility. Some improvements regarding pain were larger in the goal-setting subgroup.

Home exercise influences self-efficacy for mood and fatigue, physical capacity, and pain. Additional cognitive treatment seems to positively influence the perception of pain.