The authors showed that a short-term intensive exercise program in active rheumatoid arthritis is more effective in improving muscle strength than a conservative exercise program and does not have deleterious effects on disease activity.

Low intensity program was range of motion in a chair and supervised exercises of active assistive at a low pace, some general isometrics to all the joints of the body, and patients were encouraged to exercise on their own.

The high intensity program was the same as the program noted above; however additional exercises were done. Isometric training, three series of five contractions at 70 percent of maximum voluntary contraction of a 6 second hold at different joint angles of the lower extremity were done. Patients were allowed a 30 second rest in between.

The upper extremity was done isometrically of 6 contractions of 6 seconds alternating different muscle groups. In addition, the patients bicycled 3 times a week for 15 minutes on a home trainer and were instructed to strive for 60-70 percent of their maximum predicted heart rate.

Patients were analyzed at 3,6,12, and 24 weeks after admission. The group that had the intensive program improved significantly on all parameters, physical functioning, muscle strength, and disease activity. This program breaks some of the myths that therapists hold about exercising intensity, especially during an active stage of rheumatoid arthritis. I think this is a wonderful study and debunks some of the myths about intense strength training.