Effects of Locomotion Training on Bone Mineral Density in Patients with Rheumatoid Arthritis

Objectives: This study aimed to evaluate the effects of locomotion training on bone mineral density (BMD) and the factors associated with increased BMD in patients with rheumatoid arthritis (RA). Methods: We enrolled 85 patients with RA who underwent locomotion training for 6 months after receiving instructions from a physical therapist. We evaluated the BMD of the lumbar spine, total hip, and femoral neck 1 year before baseline (the start of locomotion training) and 1 year after baseline. Results: The change in BMD from 1 year before baseline (non-exercise period) and 1 year after baseline (exercise period) were 0.1 +/- 3.1% and 1.6 +/- 3.7% (P=0.007) for the lumbar spine, -0.2 +/- 2.4% and 1.0 +/- 2.4% (P=0.005) for the total hip, and -0.6 +/- 3.9% and 1.8 +/- 3.5% (P<0.001) for the femoral neck, respectively. The Health Assessment Questionnaire Disability Index score at baseline was associated with increased BMD at the femoral neck. No factor was associated with increased BMD in the lumbar spine or total hip. Conclusions: Locomotion training increased the BMD of the lumbar spine, total hip, and femoral neck during the exercise period compared with that during the non-exercise period. The current treatment for RA and osteoporosis accompanied by optional therapy with locomotion training might be effective in increasing BMD in patients with RA.