High Intensity Training in patients with rheumatoid arthritis

INTERVENTION: The intervention group will participate in strength training three times a week in a 75‐minute training program for 12 weeks. Eight major muscle groups will each be trained in three sets of eight repetitions at approximately 80% of maximum performance and a couple minutes of rest between each set. Each participant's maximum performance will be tested at baseline and every other week thereafter. Every training occasion starts with five minutes of warming up and ends with 10 minutes' cool down. Two weekly training sessions take place in training machines under the supervision of a physiotherapist. One weekly session is performed in the participants' home with the help of an instructive DVD and with their own body weight and rubber bands as resistance. The control group continues their normal contacts with the health care, which during the time of the intervention does not include strength training. At the end of the intervention they will be offered the same strength training program. Patients will be followed up for three months for the intervention group and three months for the control group. CONDITION: Rheumatoid arthritis (RA) ; Musculoskeletal Diseases ; Seropositive rheumatoid arthritis PRIMARY OUTCOME: Static and isokinetic muscle strength in knee extensors and knee flexors measured electronically with the Kin‐Com.; ; Both the primary and the secondary outcomes will be measured at baseline and at three month follow up. SECONDARY OUTCOME: 1. Clinical outcome (body functions, pain, fatigue and perceived health); 2. Inflammation; 3. Pain mechanisms; 4. Comorbidity; 5. Muscle biopsies from vastus lateralis analysed for reactive oxygen species/reactive nitrogen species and expression of oestrogen receptors in muscles from patients with RA patients and controls before and after the intervention; ; Both the primary and the secondary outcomes will be measured at baseline and at three month follow up. INCLUSION CRITERIA: 1. Twenty female patients after menopause 2. RA according to American College of Rheumatology criteria 3. Less than 12 months since diagnosis 4. Stable medication since at least three months 5. Independent in daily living 6. Passed menopause 7. Speak and understand Swedish 8. No other major disease that prevent them from performing intensive strength training