Physical Activity, Sports and Rheumatoid Arthritis

Rheumatoid arthritis as anarcheotype of chronic inflammatory disease with significant metabolic and cardiovascular impacts proceeds the progressive loss of muscle mass, strength and endurance. The physical inactivity, affecting most patients with rheumatoid arthritis, results in an impaired course of the disease itself, metabolic comorbidities such as diabetes, obesity and osteoporosis as well as a serious cardiovascular risk with increased mortality. In spite of their impressive clinical achievements, the innovative treatment strategies of the biological era are not sufficient to solve these problems. Nevertheless, they off er unique opportunities for patients with chronic rheumatic diseases to participate early and for the long-term in physical exercise. The preventive and curative potential of physical activity for most diseases is beyond dispute, however, it is considerably underestimated in the clinical context. The feasibility of an intensive physical exercise for patients with rheumatoid arthritis is almost ignored so far, although all studies reveal an enhancement of strength and fitness without negative impacts on joint structure or disease activity. Significant data concerning the long-term metabolic and cardiovascular effects are still lacking, however an early and continuous physical training in the context of a modern therapeutic strategy can be considered advantageous and safe for almost all patients with rheumatoid arthritis. An ideal concept would be the integration of a dynamic and combined training of strength, aerobic fitness and flexibility tailored for the particular disease activity and fitness status into the therapeutic scheme and lifestyle of the patient.