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The effect of isometric exercise of the hand on the synovial blood flow in patients with rheumatoid arthritis measured by color Doppler ultrasound

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Abstract

In 90% of patients with rheumatoid arthritis (RA), the joints of the hand are affected. Studies of grip strength training have not indicated a negative effect on disease activity after training. Introduction of ultrasound Doppler (USD) to measure increased blood flow induced by inflammation has made it possible to investigate the direct effect on blood supply in the synovium after training. In this case–control study, 24 patients with RA with USD activity in the wrist joint participated. The USD activity was measured by the color fraction (CF) (CF = colored pixels/total number of pixels in ROI). Twenty-four patients were assigned to an 8-week grip strength training program. At baseline and after 8 weeks of training, an USD examination of the wrist joint was performed. In the training group, we measured grip strength and pain in the wrist joint. Six patients withdrew from the training because of pain or change in medication. Eighteen patients served as control group. There was a modest, not significant, decrease in the CF in response to training (1.86%; P = 0.08). Grip strength increased 8.8% after training (P = 0.055). Pain in motion deceased after training (P = 0.04). No difference in the CF was seen between the training and control groups, neither at baseline nor at follow-up (P = 0.82 and P = 0.48). Patients withdrawing from training had a significantly higher CF than the other patients (P > 0.001). The results in this study might indicate that the flow in the synovium assessed by USD is not affected by grip strength training.

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Acknowledgments

The study received financial support from the following foundations: The Oak Foundation, the Danish Physiotherapy Foundation, Praksisfonden and Aase and Ejnar Danielsens Fond.

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Authors and Affiliations

  1. The Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark

    Karen Ellegaard, Søren Torp-Pedersen, Marius Henriksen, Bente Danneskiold-Samsøe & Henning Bliddal

  2. Institute for Sports Science and Clinical Biomechanics, Research Initiative for Physical Therapy, University of Southern Denmark, Odense, Denmark

    Hans Lund

  3. ProCare ApS, Tjærevej 61, 4000, Roskilde, Denmark

    Kirsten Pedersen

  4. Center for Sensory-Motor Interaction, Aalborg University, Fredrik Bajers Vej 7, D3, 9220, Aalborg, Denmark

    Bente Danneskiold-Samsøe & Henning Bliddal

Authors
  1. Karen Ellegaard
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  2. Søren Torp-Pedersen
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  3. Hans Lund
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  4. Kirsten Pedersen
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  5. Marius Henriksen
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  6. Bente Danneskiold-Samsøe
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  7. Henning Bliddal
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Correspondence to Karen Ellegaard.

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Ellegaard, K., Torp-Pedersen, S., Lund, H. et al. The effect of isometric exercise of the hand on the synovial blood flow in patients with rheumatoid arthritis measured by color Doppler ultrasound. Rheumatol Int 33, 65–70 (2013). https://doi.org/10.1007/s00296-011-2314-z

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  • DOI: https://doi.org/10.1007/s00296-011-2314-z

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