Can progressive resistance training reverse cachexia in patients with rheumatoid arthritis? Results of a pilot study

Objective. A Phase II trial was performed as a preliminary test of the efficacy and safety of progressive resistance training (PRT) as adjunct treatment for rheumatoid cachexia. Methods. Ten mildly disabled patients with well-controlled rheumatoid arthritis (RA) trained, on average, 2.5 times per week for 12 weeks. Ten age and sex matched RA patients with similar disease characteristics were non-randomly assigned to a control group. Body composition, physical function, and disease activity were assessed pre and post intervention period. Results. Between group comparisons at followup by ANCOVA using baseline scores as covariate showed significant increases in fat-free mass (+1253 g, p = 0.004), total body protein (+1063 g, p = 0.044), and arm (+280 g, p = 0.005) and leg (+839 g, p = 0.001) lean mass (a proxy measure of total body skeletal muscle mass) in response to PRT with no exacerbation of disease activity. There was also a trend for loss of fat mass in the trunk (-752 g, p = 0.084) and a significant reduction in percent body fat (-1.1%, p = 0.047). Changes in body composition were associated with improvements in various measures of physical function. Conclusion. Intense PRT with adequate volume seems to be an effective and safe intervention for stimulating muscle growth in patients with RA. Pending confirmation of these results in a larger randomized controlled trial that includes patients with more active and severe disease, a similar PRT program should be included in the management of RA as adjunct treatment for cachexia.