Exercise training and dexamethasone iontophoressis in rheumatoid arthritis: A case study

This case study was designed to evaluate the effectiveness of dexamethasone iontophoresis alone and with a supervised exercise training program on muscular strength, joint performance and cardiorespiratory endurance in a 37-year-old woman with rheumatoid arthritis. Phase I of the treatment (8 weeks) was developed to determine the effectiveness of dexamethasone iontophoresis to the knee joint (3 X each week), with one knee joint receiving the dexamethasone and the other knee receiving a placebo. In phase II (48 weeks) the subject had both knee joints phoresed with dexamethasone and received range of motion exercises (without resistance) to both knee joints. The supervised training program, phase III (12 weeks) consisted of cycle ergometry, low-resistent knee exercise and continued iontophoresis to both knee joints. The subject was assessed before and after each phase. Muscle strength improved in phase I and III with the greatest increase in phase III. Range of motion and swelling improved during all phases. Cardiorespiratory endurance improved only in phase III. Further research in this area involving a larger number of patients and a variety of joints is needed to determine the true effectiveness of the regimen.