No abstract

Prostaglandin F2 alpha (PGF2 alpha), prostaglandin E2 (PGE2) and thromboxane B2 (TXB2) levels were determined by radioimmunoassay (RIA) in knee joint fluid in two groups of patients with classical or definite rheumatoid arthritis (RA). One group had no treatment for one week prior to the study. The second group consisted of patients who developed acute exudative arthritis despite the use of various non-steroidal anti-inflammatory drugs (NSAID). The main metabolites of PGF2 alpha in plasma and urine were measured in the untreated group. The conclusion to be drawn from this study are: 1) Treatment with NSAID effectively lowers PGF2 alpha and PGE2 and TXB2 levels in joint fluid. 2) Signs and symptoms of arthritis may persist in spite of lowered levels of PGF2 alpha and PGE2 in the joint fluid. 3) The main metabolites of PGF2 alpha in plasma and urine are above the low-normal limit in untreated patients. 4) The ratio TXB2/PG was low in untreated patients, suggesting that the thromboxane pathway is quantitatively minor in rheumatoid joint inflammation.

Twenty-three patients with rheumatoid arthritis were retested about 6 months after 5 weeks' physical conditioning and 7 patients from a former control group were also retested. Former training group patients, who had continued to train about 4 times or more per week, had maintained the improved physical status obtained during the initial conditioning, while those patients who had trained less than that or discontinued training, had lost some or most of their improvement. The physical status in the former control group was virtually remained unchanged. Joint status in the former training group was no different at re-test than at post-training or pre-training examinations. A questionnaire, given to the training group patients. Four patients from this group returned to work had positively affected the daily physical activity of these patients. Four patients from this group returned to work after the hospital training program.

Thirty-four patients with rheumatoid arthritis, aged 38 to 63 years (mean age 56 years), were studied before and after a 6-week stay in hospital. Twenty-three of these patients underwent special physical training twice a day during this period. Physical performance, cardio-respiratory fitness and muscle strength improved significantly in the training group. In the control group there were no major changes in these measurements during this period except for an increase in muscle strength. Perceived exertion during submaximal exercise was much lower in the training group following the conditioning. Joint status was virtually unchanged over the experimental period in both groups. It is postulated that the low physical performance seen in these types of RA patients may, to a large extent, be attributed to lack of physical activity.