SYSTEMATIC REVIEW   Free access

European Journal of Physical and Rehabilitation Medicine 2017 October;53(5):775-87

DOI: 10.23736/S1973-9087.16.04534-2

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

The practice of physical activity and cryotherapy in rheumatoid arthritis: systematic review

Daniele PERES ¹ ✉, Yoshimasa SAGAWA Jr ^{2, 3}, Benoit DUGUÉ ⁴, Susana C. DOMENECH ⁵, Nicolas TORDI ¹, Clement PRATI ^{1, 6}

¹ PEPITE EA4267 (Exercise Performance Health Innovation - EPHI) University of Bourgogne Franche-Comté, Besançon, France; ² Laboratory of the Clinic Functional Exploration of the Movement (LEFCM), CHRU Besançon, Besançon, France; ³ Integrative and Clinical Neurosciences EA481, Bourgogne Franche-Comte University, Besançon, France; ⁴ Faculty of Sport Sciences, University of Poitiers, Laboratory “Mobility, Aging and Exercise (MOVE)”, Poitiers, France; ⁵ Center of the Sciences in the Health and Sport - CEFID, University of the Santa Catarina State Florianópolis, Santa Catarina, Brazil; ⁶ Department of Rheumatology, CHRU Besançon, Besançon, France

INTRODUCTION: Rheumatoid arthritis (RA) is an autoimmune, chronic and inflammatory disease, which the affected patients present a higher cardiovascular mortality rate. Physical activities have been identified as the most important strategy to prevent cardiovascular diseases. However, the articular damage and the chronic pain caused by RA challenges its regular practice. Moreover, persons with RA tend to avoid PA due to the fear of exacerbating the inflammatory potential and pain. One alternative to avoid the collateral effects of the PA could be the cryotherapy. Therefore, this study aimed to review studies focused on the use of both PA and cryotherapy in RA patients and to identify evidences that both therapies could be combined in order to optimize the symptomatic treatment.
EVIDENCE ACQUISITION: Four databases (MEDLINE, CINAHL, Elsevier and PEDro) were searched to identify publications regarding RA patients, PA and cryotherapy intervention by the terms and operators (rheumatoid arthritis AND exercise OR physical activity OR activity OR training OR reconditioning OR cryotherapy OR cold OR immersion). The selected studies should at least present one measure of the aerobic capacity, disease activity or pain relief. Among 19 studies with RA patients identified, only 4 studies used PA combined with cryotherapy. The other 13 studies used physical activities and 2 studies used cryotherapy intervention.
EVIDENCE SYNTHESIS: The results of the physical activities combined with cryotherapy studies showed an improvement in the disease activity and pain relief, however without details of the physical activities intervention and an aerobic capacity. Among the physical activities studies, evidence was found suggesting that aerobic exercises and multiactivity exercises with high intensity are the more effective for improve the aerobic capacity.
CONCLUSIONS: Even if few studies on cryotherapy were found, there are enough evidences in the literature that demonstrate the benefits of this intervention on pain relief and disease activity. In summary, neither study found associated physical activities to improve aerobic capacity with cryotherapy to improve disease activity and pain relief. This may be an innovative therapeutic strategy to improve the aerobic capacity in arthritis patients and consequently reduce their cardiovascular risk while minimizing pain and disease activity.

KEY WORDS: Arthritis, rheumatoid - Exercise - Cryotherapy - Disease progression