The ultimate cause of limb fractures is usually a fall, which means that any strategy to prevent fractures must address not only bone strength but also the tendency to fall (ESHRE-Group-Capri, 2010).
Stanmore et al. (2013b) referred that in future investigations should be studied falls prevention programs that incorporate exercises specifically target to lower extremity muscle strength and challenge balance. Two systematic reviews (Gillespie et al., 2012; Sherrington et al., 2008) provided strong evidence that exercise programs can reduce fall rates in elderly, namely proprioceptive exercises. Nonetheless, the findings observed by Aleixo et al. (2017) and Silva et al. (2010) led us to conclude that more investigation is required to understand the safety and efficacy of proprioceptive exercises on rheumatoid arthritis (RA) patients. Thus, our investigation was one more important contribution to strengthen the knowledge in relation to safety and efficacy of proprioceptive exercises on RA patients.
Gait is one of the main daily activities in which falls occur and literature pointed to some gait biomechanical variables related with falls. However, few investigations assessed the gait of RA patients or post-menopausal women, leaving many questions unanswered. This investigation enabled to understand the gait changes that occur as result of the disease (i.e., through the comparison between RA postmenopausal women and healthy postmenopausal women), increasing the scarce knowledge on this issue. But more important than this, it was the first investigation that studied the effects of an individualized proprioceptive exercises program on the gait kinematic and kinetic variables of RA post-menopausal women.
Finally, it is important to highlight the kind of program developed in our investigation, i.e., an individualized exercises program. In the reviewed investigations, group exercises programs were the majority of interventions. Cairns & McVeigh (2009), in their systematic review, suggested that exercise programs should be carefully tailored to the individual. Therefore, our investigation also incorporated the assessment of a different approach in the way of developing exercise programs, which has been poorly studied.
Aleixo, P., Tavares, C., Vaz Patto, J., & Abrantes, J. (2017). Segurança e eficácia dos exercícios propriocetivos em doentes com artrite reumatóide (revisão sistemática). Gymnasium, 2(1). Retrieved from http://g-se.com/es/journals/gymnasium/articulos/seguranca-e-eficacia-dos-exercicios-propriocetivos-em-doentes-com-artrite-reumatoide-revisao-sistematica-2204
Cairns, A., & McVeigh, J. (2009). A systematic review of the effects of dynamic exercise in rheumatoid arthritis. Rheumatology International, 30(2), 147–158.
ESHRE-Group-Capri. (2010). Bone fractures after menopause. Human Reproduction Update, 16(6), 761–773.
Gillespie, L., Robertson, M., Gillespie, W., Sherrington, C., Gates, S., Clemson, L., & Lamb, S. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (2).
Sherrington, C., Whitney, J., Lord, S., Herbert, R., Cumming, R., & Close, J. (2008). Effective exercise for the prevention of falls: a systematic review and meta-analysis. Journal of the American Geriatrics Society, 56(12), 2234–2243.
Silva, N., Moto, A., Almeida, G., Atallah, A., Peccin, M., & Trevisani, V. (2010). Balance training (proprioceptive training) for patients with rheumatoid arthritis. Cochrane Database of Systematic Reviews, 12(5).
Stanmore, E. K., Oldham, J., Skelton, D. a., O’Neill, T., Pilling, M., Campbell, a. J., & Todd, C. (2013). Risk factors for falls in adults with rheumatoid arthritis: a prospective study. Arthritis Care & Research, 65(8), 1251–1258.