Predictors of exercise and effects of exercise on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid arthritis.

OBJECTIVE: To determine the effects of participation in a low-impact aerobic exercise program on fatigue, pain, and depression; to examine whether intervention groups compared with a control group differed on functional (grip strength and walk time) and disease activity (total joint count, erythrocyte sedimentation rate, and C-reactive protein) measures and aerobic fitness at the end of the intervention; and to test which factors predicted exercise participation. METHODS: A convenience sample of 220 adults with rheumatoid arthritis (RA), ages 40-70, was randomized to 1 of 3 groups: class exercise, home exercise using a videotape, and control group. Measures were obtained at baseline (T1), after 6 weeks of exercise (T2), and after 12 weeks of exercise (T3). RESULTS: Using structural equation modeling, overall symptoms (latent variable for pain, fatigue, and depression) decreased significantly at T3 (P < 0.04) for the class exercise group compared with the control group. There were significant interaction effects of time and group for the functional measures of walk time and grip strength: the treatment groups improved more than the control group (P

Can dermal thickness measured by ultrasound biomicroscopy assist in determining osteoporosis risk?

BACKGROUND AND PURPOSE: A study was undertaken to evaluate the relationship between dermal thickness and bone density. Ninety-eight female subjects were recruited from a population of patients attending a university hospital osteoporosis clinic. The subject population ranged in age from 30 to 88 years with a mean age of 60. The weight range was from 91 to 274 pounds, mean 142 pounds. METHODS: Dermal thickness measurements were taken at the right forearm using a Longport high resolution 20 MHz ultrasound scanner. Bone density measurements were taken using a GE Lunar Prodigy DXA scanner at both hips. RESULTS: Statistical analysis using the intraclass correlation coefficient (ICC) of the skin measurements showed that the dermal measurement technique was highly reliable (CI=0.87, 0.92). Linear regression was used to examine the value of dermal thickness as a predictor of bone density. The correlation coefficient between dermal thickness and hip T score was statistically significant in the positive direction (corr.=0.304, P=0.001). We further investigated the relationship between dermal thickness and T scores using penalized splines. CONCLUSION: This analysis indicated that the strongest association with bone density occurred between 1.0 and 1.5 mm of dermal thickness. In those subjects identified as having osteoporosis dermal thickness measure of > or =1.04 corresponds to 4% of the subjects having osteoporosis. If dermal thickness is <1.04 then 23% have osteoporosis.