Objectives

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by joint swelling, joint tenderness, and destruction of synovial joints, factors that can lead to a severe disability.

Epidemiologic results showed that post-menopausal women are the greater percentage of RA patients. RA patients and postmenopausal women showed impairment of functional and physical capacities, and reduction of lean mass. Moreover, this loss of functionality in RA patients and post-menopausal women increases the fall risk. Gait is one of the main daily activities in which falls occur and literature pointed to some gait biomechanical variables related with falls. To the best of our knowledge, those variables were not studied in RA patients or in post-menopausal women; however, RA patients revealed changes in other gait kinematic and kinetic variables in relation to healthy subjects.

The effectiveness of exercise to improve physical and functional capacities was extensively studied. Thus, several systematic reviews and meta-analysis proofed safety and effectiveness of aerobic exercises programs and strength exercises programs in RA patients. Nonetheless, there is a lack of investigations that approach the effects of exercise programs in relation to fall risk or in relation to variables related with this risk. Literature provided strong evidence that exercise programs can reduce fall rates in older people, namely balance and coordination exercises (proprioceptive exercises).

Since RA patients are at risk concerning falls and proprioceptive exercises could play an important role in preventing falls and increasing functional capacity and stability, it will be important to conduct investigations that try to understand the efficacy and safety of these exercises in these patients. The authors of a systematic review (Silva et al., 2010) that dealt with these issues could not find any RCT or clinically controlled trial, concluding that more investigations were required. More recently we conducted a new systematic review to critically evaluate the clinical trial evidence for effectiveness and safety of proprioceptive exercises in RA patients (Aleixo et al., 2017). It was concluded that the existing investigations that approach efficacy and safety of proprioceptive exercises in RA patients are scarce, although the few investigations pointed to its safety and effectiveness. Therefore, the effects of proprioceptive exercises in RA patients are not totally known, especially in gait kinematic and kinetic variables. Thus, this investigation was conceived to assess the effects of proprioceptive exercises on RA post-menopausal women. Specifically, the objectives were to assess the effects on:

• disease activity;

• functional capacity;

• body composition;

• gait kinematics and kinetics, and in its intra-individual variability.

In order to strengthen the study of these effects, it would be important a comparison between RA post-menopausal women and a group of healthy post-menopausal women. So, a secondary endpoint of this investigation was to compare RA post-menopausal women with healthy post-menopausal women, in relation to functional capacity, body composition, gait kinematics and kinetics, and its intra-individual variability. Another secondary endpoint of this investigation was to correlate, in RA postmenopausal women, the functional disability and the kinematic and kinetic variables.