For patients with rheumatoid arthritis (RA), both neuromuscular electrical stimulation and high-intensity volitional resistance training can effectively improve muscle structure and function, according to results published in Arthritis Care & Research.
Some patients with RA may be unable to tolerate high-intensity resistance exercise, or it may be contraindicated. Neuromuscular electrical stimulation may be a viable alternative for these patients, although attrition must be considered.
The study included adults with RA who were assigned to receive 36 sessions of neuromuscular electrical stimulation (n=31) or volitional training (n=28) over the course of 16 weeks. Outcome measures included muscle structure and function (measured using quadriceps muscle area, density, and strength), performance-based and patient-reported physical function, feasibility (measured by pain, disease activity, attrition, and adherence), and myocyte characteristics (measured using area, proportion of type I or II muscle fibers, and intramyocellular lipid content).
The intensity of the neuromuscular electrical stimulation intervention was significantly less compared with the volitional intervention (31% vs 77% of maximum effort).
Participants in both groups experienced significant improvements in muscle structure and function (P values from <.001 to .019). Improvements in muscle characteristics and physical function did not differ between the groups.
In the neuromuscular electrical stimulation group, attrition was 29% compared with 7% in the volitional group. The researchers also note that the exercises did not result in serious adverse events or increases in pain and disease activity.
Piva SR, Khoja SS, Toledo FGS, et al. Neuromuscular electrical stimulation compared to volitional exercise in improving muscle function in rheumatoid arthritis: a randomized pilot study [published online May 21, 2018]. Arthritis Care Res. doi: 10.1002/acr.23602