A physically demanding occupation predicts premature retirement among patients with erosive arthritis

Abstract

The aim of this study was to assess the intensity of exercise and energy expenditure of patients with recent onset inflammatory arthritis in their occupational environments and leisure time physical activities. The exercise intensities and energy expenditures of 41 early inflammatory arthritis patients and 20 matched healthy controls were assessed in occupational work and in leisure time physical activities during a 3.5-year follow-up using metabolic unit values. Disease activity was assessed by erythrocyte sedimentation rate and Ritchie's articular index. Subjective disability was assessed by the Stanford Health Assessment Questionnaire and the extent of joint damage on X-rays of the hands and feet following the method of Larsen et al (1977). Furthermore, 21 patients initially carried out progressive strength training for a 6-month period, while the rest of the subjects only maintained their daily physical activities. Our results indicate that the high physical requirements of occupational work were related to the development of joint destruction, work disability and the premature professional retirement of the inflammatory arthritis patients. The exercise intensities and energy expenditures in leisure time physical activities were lower when compared with daily work and were of minor importance. However, the 6-month strength training had a positive impact on patient outcome. Patients in physically demanding jobs who contract inflammatory arthritis need early occupational and physical rehabilitation to prevent progressive structural joint damage and premature retirement.