Total value of intensive exercise training (three weeks) immediately after hospital discharge for arthritis patients due to a flare of disease activity or for elective joint replacements

INTERVENTION: Directly following hospital discharge the patients of this study design recieved Intensive Exercise Therapy (IET) or Usual Care (UC). The IET group were referred to a dedicated convalescent ?hotel?. The hotel facilities and professional care for disabled people were offered for three‐weeks. Thereafter, the IET group received regular care only. During their three week stay patients were trained twice a day by physical therapists, for 75 minutes per session. The goals of the training were improvement of range of motion, muscle strength, aerobic capacity and activities of daily life. The therapy sessions were given individually as well as in groups. In the first two weeks, treatment focused on individual limitations (range of motion, strength, balance, aerobic capacity and simple functionality). Aerobic capacity was trained daily on a sub maximal level. Hydrotherapy was applied after sufficient wound healing. During the third week, the training was focused on the functional capacities as prioritised by the patient. A group education program was given twice a week. This program was based on the self management training for arthritis patients by Kate Lorig modified for the Netherlands by Taal. In contrast, the patients in the UC group received usual care at the discretion of their attending physician only. Usual care consists of either physical therapy by a local physical therapist or temporary admission to a nursing home, when applicable. CONDITION: Rheumatoid arthritis and Osteoarthritis ; Musculoskeletal Diseases ; Arthropathies PRIMARY OUTCOME: Function ability as measured with the McMaster Toronto Arthritis patient preference questionnaire (MACTAR) and Health Assessment Questionnaire (HAQ). SECONDARY OUTCOME: 1. Quality of life as measured with the RAND‐36/Short Form health survey (SF‐36) and Arthritis Impact Measurement Scales (AIMS); 2. Mobility as measured with the Escola Paulista de Medicina Range Of Motion (EPM‐ROM); 3. Pain, general health as measured with a Visual Analogue Scale; 4. Costs INCLUSION CRITERIA: 1. Aged over 18 2. Rheumatoid Arthritis (RA) according to the American College of Rheumatology (ACR) 1987 or polyarticular OsteoArthritis (OA)