Home exercise and compliance in inflammatory rheumatic diseases--a prospective clinical trial

To survey and to compare the one year effects of dynamic muscle training and progressive muscle relaxation as home exercise for patients with inflammatory rheumatic diseases; and to identify predictors for compliance with a longterm home exercise regimen.

Fifty-four patients (mean age 54 yrs, mean symptom duration 14 yrs) were assessed for health related quality of life, exercise motivation, joint tenderness, and physical capacities. After randomization into 2 groups, every patient was instructed on one occasion in a 30 min program of either dynamic training or muscle relaxation to carry out at home, 5 times a week during 3 months, and then 2-3 times a week for another 9 months.

Seventeen patients in each group completed the one year exercise protocol, while 10 from each group did not. Compliance with the one year exercise regimen seemed to be predicted by high self-efficacy for exercise, regular range-of-motion exercises before the intervention, and being unmarried. After one year, minor improvements in physical effect (p < or = 0.05) and work effect (p < or = 0.05) were found in the dynamic training group, while minor improvements in pain effect (p < or = 0.05), emotional reactions (p < or = 0.05), and arm endurance (p < or = 0.01) were found in the muscle relaxation group. No differences between the groups regarding changes in health status, joint tenderness, or physical capacities during the intervention period were found.

These results may improve the selection of patients for home exercise, and form a basis for improved administration of home exercise programs.