The interest in studying the impact of aquatic exercise on muscle strength of patients with
rheumatoid arthritis came after publication of several studies that pointed to the potential
benefit of exercise on the natural history of the disease, including reduction of pain,
better immune response as well as aerobic fitness and functional capacity and increase muscle
strength, endurance and quality of life.
In general, the aquatic exercises are indicated for patients with chronic joint diseases,
since the aquatic environment seems to be more secure for this population due to the
reduction of joint loading, as well as gain range of motion.
However, there are some difficulties to show the real and consistent beneficial effect of
physical activity in these patients, such as the small number of randomized controlled
clinical trials, short intervention period (4-8 weeks), lack of details of the exercise
protocols used, methodological problems (heterogeneous measures to evaluate the outcome,
change of medication). Moreover, no study evaluated the disease activity, according to the
tool most used clinically worldwide, the DAS28.
It is known that aquatic exercises without impact in healthy subjects are sufficient to gain
muscle strength. Nonetheless, in people with joint limitation the benefits from these same
exercises to gain muscle strength is not known.
To date, no studies addressing the effect of aquatic exercise on muscle strength and disease
activity in patients with rheumatoid arthritis. In addition, there is the need to obtain a
standardized protocol for prescribing of aquatic exercises. The choice of lower-limb strength
was based on its relevance to the acceleration and deceleration during the march, as well as
to perform activities of daily living, leisure and professional in these individuals.
Thus, this study aims at:
1. Exercises performed in the aquatic environment and without the concomitant use of
overhead equipment are sufficient to promote gain muscle strength in the lower limb?
2. What is the isolated effect of water resistance on muscle strength? Could it work as an
impact that is used in exercises done on the land?