BACKGROUND: At present, there are many therapeutic studies on drugs for preventing or postponing the destruction of joint and alleviating the pain in patients with rheumatoid arthritis (RA). However, what is the effect of aerobic exercise combined with medicative therapy on the quality of life in patients with RA? OBJECTIVE: To evaluate the effect of aerobic exercise combined with medicative therapy and single medicative therapy with quality of life (QOL) questionnaire for patients with RA. DESIGN: Randomized and controlled trial. SETTING: Department of Rehabilitation Medicine and Department of Rheumatology, Affiliated Hospital of Luzhou Medical College. PARTICIPANTS: Totally 148 patients with RA accepting treatment in the Department of Rehabilitation Medicine and Department of Rheumatology, Affiliated Hospital of Luzhou Medical College between December 2003 and July 2004 were recruited. Altogether 126 patients were involved, including 24 male and 102 female, and all of them participated in this trial voluntarily. The patients were randomized into aerobic exercise group (n = 85) and control group (n = 41). METHODS: Patients in the aerobic exercise group were given aerobic exercise four times a week, 30 min/time for 12 weeks on the basis of the medicative therapy (methopterin mainly). Patients in the control group were given only the routine medicative therapy. Quality of life questionnaire for patients with rheumatoid arthritis was used to score the patients in the two groups before and 3 months after the therapy. Test methods: each item of the questionnaire was rated on a 5-point questionnaire, and the score of each sub-questionnaire was calculated. Weighting method was applied in scoring the quality of life. In order to avoid the influence of initial value before therapy, the ameliorative value was adopted in the comparison of QOL between the two groups (ie, value before therapy minus value after therapy) and the percent of amelioration (ameliorative value/value before therapy x 100%). MAIN OUTCOME MEASURES: Scores of the QOL before and after therapy in patients with RA. RESULTS: According to intention-to-treat analysis, 126 of the 148 patients were recruited in this trial and all the 126 patients entered the result analysis. (1) Comparison of the score of QOL of the patients in the two groups before aerobic exercise: There was no significant difference of the score of physical, emotional/psychological, social functions, self-recognized health status and overall QOL between the aerobic exercise group and the control group (aerobic exercise group: 17, 19, 14, 20, 1.8 scores respectively; control group: 17.5, 20, 14, 21, 1.7 scores respectively, p > 0.05). (2) Comparison of the score of QOL of the patients in the two groups after aerobic exercise: the score of physical, emotional/psychological, social functions, self-recognized health status and overall QOL of the patients in the aerobic exercise group was all higher than that in the control group (aerobic exercise group: 3.5, 2.0, 3.0, 20, 3.4 scores respectively; control group: 2.0, 1.4, 1.6, 0, 2.0 scores respectively, p < 0.05). (3) Ameliorative condition of QOL of the patients in the two groups after therapy: the score of physical, emotional/psychological, social functions, self-recognized health status and overall QOL of the patients in the aerobic exercise group after therapy was ameliorative as compared with that before therapy (12% to 28%), which was superior to that in the control group. CONCLUSION: Aerobic exercise combined with medicative therapy has obviously ameliorative effect on psychological function and self-recognized health status as compared with that of single medicative therapy, and it also improves the muscular power and the desire to participate in exercise as well as the function of joint motion.

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