Effect of lower limb exercise therapy on the patients with rheumatoid arthritis: an analysis based on severity of joint damage.

Abstract

Objective: Exercise therapy is widely recommended for patients with rheumatoid arthritis (RA), but the ideal parameters and appropriate patients selection remain controversial. This study aimed to assess the effectiveness and safety of lower limb exercise therapy in RA-affected knees, stratified by radiographic severity of joint destruction.

Methods: We retrospectively analyzed RA patients who participated in a three-month lower limb exercise therapy. Participants were divided into two groups according to the Larsen grading classification: mild destruction (LG II-III) and advanced destruction (LG IV-V). Functional outcomes and disease activity parameters were compared between two groups of LG II-III and IV-V.

Results: Patients in the LG II-III group showed improvements in lower limb functions, including enhanced strength of the gluteus muscles, with no worsening of RA disease activity. Conversely, some patients in the LG IV-V group experienced declines in the 10-meter walk time, timed up and go test (TUG), patient visual analogue scale (VAS), and stair climbing ability. Some patients in the LG IV-V group had intensified anti-rheumatic drug therapy.

Conclusion: Lower limb exercise therapy appears safe and effective for RA knees with mild destruction but may risk functional decline in patients with advanced damage. Radiographic evaluation is essential for tailoring therapy to individual joint status.