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The aim of this study is to investigate respiratory muscle strength, respiratory muscle endurance, muscle oxygenation, upper extremity and lower extremity exercise capacity in rheumatoid arthritis patients compared with healthy individuals.
Rheumatoid arthritis (RA) is a chronic progressive autoimmune disease of unknown etiology with symmetric erosive synovitis and multisystem involvement. The disease causes significant long-term morbidity, reduced functional capacity, and increased mortality rates. Patients with rheumatoid arthritis avoid physical activity due to pain and fatigue. Despite the advances in pharmacological treatments in recent years, functional losses due to rheumatic diseases the resulting deterioration in quality of life, and loss of work continue. Physical inactivity is known to have detrimental effects on the cardiovascular and pulmonary systems by reducing muscle strength and aerobic capacity. The physiological reasons underlying skeletal muscle oxygenation that may cause muscle dysfunction in rheumatoid arthritis have not been investigated. In these patients, decreased arterial oxygen may reduce exercise capacity and cause muscle deoxygenation.
In rheumatoid arthritis patients, decreases in respiratory muscle strength, lung volumes, oxygen consumption, and six minute walk test distance cause cardiopulmonary deconditioning. Decreased exercise capacity increases the risk of cardiovascular disease and causes mortality in patients with RA.
This study aimed to, the effects of respiratory muscle strength, respiratory muscle endurance, upper and lower extremity muscle oxygenation, and upper and lower extremity exercise capacity in patients with stable disease activity.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rheumatoid Arthritis Group | Rheumatoid arthritis patients who are followed up in the Rheumatology Outpatient Clinic of the Department of Physical Medicine and Rehabilitation (diagnosed according to American College of Rheumatology/European Alliance of Associations for Rheumatology ACR/EULAR 2022 diagnostic criteria), aged between 18-65 years, and have a Disease Activity Score (DAS) -28 score below 2.6 in disease remission will be included. | ||
| Control Group | As a control group, healthy individuals between the ages of 18-65, who are similar to the patients in terms of age and gender, without any disease, will be included in the study. Healthy individuals in the control group will be selected from volunteer colleagues, school friends, family and residential areas of the researchers to participate in the study. |
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| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of respiratory muscle strength | An electronic mouth pressure measuring device that complies with American Thoracic Society and European Respiratory Society criteria will be used to assess respiratory muscle strength. | First day |
| Evaluation of respiratory muscle endurance | The incremental threshold workload test will be used to assess respiratory muscle endurance.The PowerBreathe Wellness® (HaB International Ltd. Southam, United Kingdom) inspiratory muscle training device will be used in the incremental threshold load test. | First day |
| Evaluation of Deltoid and Quadriceps Femoris Muscle Oxygenation | Muscle oxygen level of quadriceps femoris and deltoid muscles will be measured using Moxy® monitor (Moxy, Fortiori Design LLC, Minnesota, USA) before, during and after the six-minute walk test and six-minute peg-board and ring test. | First and second day |
| Evaluation of Deltoid and Quadriceps Femoris Muscle Total Hemoglobin Level | Total hemoglobin level of quadriceps femoris and deltoid muscles will be measured using Moxy® monitor (Moxy, Fortiori Design LLC, Minnesota, USA) before, during and after the six-minute walk test and six-minute peg-board and ring test. | First and second day |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of submaximal exercise capacity | The six-minute walk test will be performed according to American Thoracic Society criteria to evaluate functional exercise capacity. | First day and second day |
| Evaluation of upper extremity capacity |
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Rheumatoid Arthritis Group
Inclusion Criteria:
Exclusion Criteria:
Control Group
Inclusion Criteria:
Exclusion Criteria:
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Rheumatoid arthritis patients (diagnosed according to American College of Rheumatology/European Alliance of Associations for Rheumatology ACR/EULAR 2022 diagnostic criteria) aged between 18-65 years, with a Disease Activity Score (DAS)-28 score below 2.6 in disease remission and followed up at the Rheumatology Polyclinic of the Department of Physical Medicine and Rehabilitation at Kirsehir Ahi Evran University will be included in the study.
As a control group, healthy individuals between the ages of 18-65, who are similar to the patients in terms of age and gender, without any disease, will be included in the study.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Başak KAVALCI KOL, PhD | Contact | +903862802317 | basak.kavalci@ahievran.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Başak KAVALCI KOL, PhD | Kirsehir Ahi Evran Universitesi | Principal Investigator |
| Merve FIRAT, PhD | Kirsehir Ahi Evran Universitesi | Study Chair |
| Figen TUNCAY, Prof. Dr. |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kırşehir Ahi Evran University, Physical Therapy and Rehabilitation Center, Cardiopulmonary Unit | Recruiting | Kırşehir | Merkez | 40100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32010722 | Background | Wickerson L, Mathur S, Brooks D, Bonetti LV, Singer LG, Granton J, Reid WD. Skeletal muscle oxygenation and regional blood volume during incremental limb loading in interstitial lung disease. ERJ Open Res. 2020 Jan 27;6(1):00083-2019. doi: 10.1183/23120541.00083-2019. eCollection 2020 Jan. | |
| 11434466 | Background |
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All data will be stored in a locked cabinet.
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| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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The six-minute peg board and ring test will be used to assess upper extremity exercise capacity.
| First day and second day |
| Kirsehir Ahi Evran Universitesi |
| Study Chair |
| Cimen B, Deviren SD, Yorgancloglu ZR. Pulmonary function tests, aerobic capacity, respiratory muscle strength and endurance of patients with rheumatoid arthritis. Clin Rheumatol. 2001;20(3):168-73. doi: 10.1007/s100670170058. |
| D003240 |
| Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |