Changes in the Serum Interleukin 6 Levels after Rehabilitation Exercise and Hot Spring Bathing in Patients with Rheumatoid Arthritis

Abstract

We have previously reported that a depressive mental state of the patients with rheumatoid arthritis (RA) could be improved by rehabilitation exercise and hot spring bathing. These patients noticed that their muscle stiffness decreased and that they also felt mentally refreshed. In this study, the changes in the serum inflammatory cytokine levels after rehabilitation exercise and hot spring bathing in the RA patients with an active disease were evaluated and increased levels of interleukin 6 (IL-6) were found to decrease to the nearly half of the pre exercise levels. The decreases in the IL-6 levels were not attributed to the circadian rhythm and they also did not correlate with the serum cortisole levels. Next, we chose RA patients with active disease who had not been treated with any corticosteroids or exercise therapy. After exercise, the patients tended to complain of aggravated muscle stiffness and joint pain as well as discomfort. Their IL-6 levels did not show any decrease, but instead a moderate increase was observed. IL-1 receptor antagonist (IL-1ra) showed normal levels before exercise, and they did not change substantially after the exercise. As a result, when patients with active disease achieved a decrease in muscle stiffness and also felt refreshed, then their serum IL-6 levels also decreased. Such exercise therapy should be initiated when the patients' complaints have improved owning to sufficient bed rest and small doses of corticosteroids.