Physical and quality of life tests were conducted at the beginning of the study, and again at 3, 6, and 9 months. Physical tests included arm ergometry performance at workloads of 40%, 60%, and 80% of maximal heart rate and muscle strength of 1 rep max (1RM) for chest press, elbow flexion, and shoulder flexion. Quality of life components were assessed through questionnaires administered verbally. The components included stress, depression, physical self-concept, pain, perceived health, and quality of life.

Subjects were divided into an exercise group (N = 21) and a control group (N = 13). The exercise group participated in two training sessions per week for 9 months. Each session lasted 90 to 120 minutes and consisted of a warm-up, stretching, aerobic training, and strength training. Aerobic training was performed on the arm ergometer for 15 to 30 minutes at an intensity of 70% maximal heart rate. Strength training involved three sets at 70% to 80% 1RM for two exercises from each muscle group: forearm/wrist, biceps, back, chest, abdominals, shoulder, triceps, and legs when appropriate.