Effectiveness of Longstanding Exercise Therapy versus Usual Care in People with Rheumatoid Arthritis and Severe Functional Limitations: A Randomized Controlled Trial (L-EXTRA)

Poster Presenter: Max Teuwen, MSc, PhD Candidate, Leiden University Medical Center, Department of Orthopaedics, Rehabilitation and Physical Therapy, The Netherlands

Poster Title: Effectiveness of Longstanding Exercise Therapy versus Usual Care in People with Rheumatoid Arthritis and Severe Functional Limitations: A Randomized Controlled Trial (L-EXTRA)

Poster Session B: Monday, Nov. 13

What is your poster about?
“The poster presents findings from a randomized controlled trial, the L-EXTRA study (Longstanding Exercise Therapy in Patients with Rheumatoid Arthritis and Severe Functional Limitations).

“In this study, we compared the effectiveness of a 52-week personalized and supervised exercise therapy intervention with usual care in 215 people with rheumatoid arthritis (RA) and severe functional limitations. The presence of severe functional limitations was determined by means of an interview, focusing on perceived limitations in basic activities of daily living. The intervention comprised individual functional goal setting, appropriately dosed active exercises, education and self-management support, and physical activity promotion (including a wearable activity tracker and a personal activity plan) and was delivered by specifically trained physical therapists. 

“A total of 202 patients (94%) completed the 52-week assessment, and it was found that the 109 patients randomized to the intervention group had a significantly greater improvement of various measures of physical functioning and quality of life than those in the usual care group.”

“The effectiveness and safety of exercise therapy for people with RA have been well-established. However, despite the significant advancements in medical treatment for RA over the past decades, there is a considerable proportion of patients who have severe functional disability.”

— Max Teuwen, PhD Candidate

Why did you decide to investigate this topic?
“The effectiveness and safety of exercise therapy for people with RA have been well-established. However, despite the significant advancements in medical treatment for RA over the past decades, there is a considerable proportion of patients who have severe functional disability, due to factors such as persisting disease activity, joint destruction, complications of treatment, or comorbidity. Patients in this subgroup have so far been excluded from exercise trials that usually include highly selected patient groups with a favorable health status.”

What are you working on next related to this research?
“Our current research endeavors include an evaluation of the cost-utility of the intervention as compared to usual, the long-term follow-up at 104 weeks (access to treatment was available until the end of the study that ran from 2020-2023; patients in the control group could use the intervention after they passed the primary end point at 52 weeks), and the conduct of a qualitative and quantitative implementation study aiming to set up a tailored implementation strategy on the national level.”

What excites you most about your work?
“The pursuit of knowledge on a potentially effective intervention for a group of patients that is currently underrepresented in exercise research and thereby contribute to the improvement of healthcare for individuals with RA.”

What are you most looking forward to at ACR Convergence 2023 in San Diego?
“First and foremost, I look forward to immersing myself in the latest advancements and research findings in the field of rheumatology. Secondly, I am excited about the prospect of networking with esteemed experts and exchanging experiences that can enhance my professional journey. Lastly, I am eager to experience American culture and its unique influences, which will add an extra dimension to my ACR Convergence experience.”