A recent study has shown exciting new benefits associated with exercise for people living with rheumatoid arthritis (RA).
Researchers at Duke University in North Carolina found that 10 weeks of high-intensity interval walk training was associated with decreased disease activity and improved immune function for adults with RA. High-intensity interval walk training refers to a popular form of exercise that includes short bursts of fast-paced walking at maximum effort followed by less intense recovery periods.
The study included twelve physically inactive adults over the age of 55, with a confirmed diagnosis of RA. Participants completed a 10-week program consisting of 3x 30-minute sessions a week of supervised treadmill walking. This Included a 5-minute warm up and 5-minute cool down. Within the training session, participants walked at 80-90% of their maximum effort in intervals of 60 to 90 seconds. These high-intensity intervals were followed by recovery intervals at 50-60% maximum effort. Speed and interval times varied for each person based on a cardiorespitory fitness test, but none exceeded walking pace.
Disease activity was assessed by a rheumatologist through a count of swollen and tender joints, perceived general health and blood tests to measure inflammation. Cardiovascular fitness and immune functions were assessed using a variety of clinical and laboratory tests, as well as standardized questionnaires. At the end of the 10 weeks, the following outcomes were observed:
RA disease activity reduced by 38%, with a significant decrease in swollen joints, erythrocyte sedimentation rate (ESR) and improved self-perceived health. An ESR blood test measures the rate at which red blood cells settle in the period of one hour, revealing inflammatory activity in the body.
Improved immune functions suggesting a reduced infection risk and inflammatory potential
Cardiorespitory fitness increased by 9%
Resting blood pressure and heart rate both reduced
There is a substantial amount of research on exercise and rheumatoid arthritis, but few studies have reported the actual lowering of disease activity scores. As stated by the researchers, this study suggests that,
“High intensity interval walking could be an efficient, tolerable, and highly effective intervention to augment disease activity and improve overall health in patients with RA.”
There are certain limitations to the study such as the small sample size and no control group, but the findings will hopefully encourage more research in the area. In addition, these findings add to a growing body of research on the benefits of exercise for people with arthritis. To learn more about the study, click here.
To learn more about physical activity and arthritis visit the following pages:
Share your favourite “go to websites for physical activity information and guidance
A team of health and fitness professionals, researchers and patients partners from throughout BC have worked together to create a repository of online resources to guide and motivate people living with chronic health conditions to be physically active. To help them finalize their soon to be launched Physical Activity Support Kit Initiative (PASKI) website, they’re asking people with arthritis and other chronic conditions to take their 1-minute survey. Share your favourite “go to websites” for physical activity information and guidance. Survey closes February 8, 2019.
Much has been said and written about the importance of exercisefor our health and wellbeing. However, for people with arthritis, it also can help manage symptoms. While people with arthritis may be reluctant to exercise fearing joint damage, exercise is especially crucial for people living with all forms of arthritis disease. In fact, exercise is a vitally important part of a well-rounded arthritis treatment plan.
For people living with arthritis, pain, body weight, age and lack of knowledge about appropriate types of exercises may be hurdles to getting started on an exercise program. Another barrier is the lack of recommendation and referral for exercise by physicians. A Canadian study of osteoarthritis patients showed that only one third had been advised to exercise by their doctor. However, exercise has numerous physical and mental health benefits and there are no specific exercises that should be avoided by people with arthritis.
One of the most important benefits of exercise is weight management, which helps to improve body image and can improve the symptoms of arthritis, especially of osteoarthritis. If a person is heavier than their ideal body weight, even a small amount of weight loss can help reduce both the risk of developing certain types of osteoarthritis and the chances of osteoarthritis worsening with age.
For everyone, exercise helps to improve heart and lung function, but for people living with arthritis, a variety of types of exercise can help to reduce joint pain and control joint swelling. These include:
Range of motion exercises help to keep the joints mobile and are also useful for helping to prevent injuries.
Weight bearing exercises can decrease bone loss, keep weak joints stable, and reduce the risk of osteoporosis.
Aerobic exercises, such as walking, help with weight loss. As well, exercise can help make it easier to fall asleep and to sleep more soundly.
In addition to improved physical health, exercise has many psychological benefits. Pain can seem more pronounced when we are unhappy or upset and exercise can help reduce depression. Additionally, it can improve self-esteem and self-confidence, improve the ability to relax, improve mood and wellbeing, and promote a good body image. Exercise also provides a good outlet for dealing with stress and anxiety.
Research suggests that most types of physical activity do not cause or worsen arthritis. In contrast, a lack of physical activity is associated with increased muscle weakness, joint stiffness, reduced range of motion, fatigue and overall reduced physical fitness.
Once a regular pattern of exercise has been established, it is important to maintain this pattern.
In order to get the benefits of exercise, it is vital to stay active.
Research shows that in people with osteoarthritis, once exercise stops, the reduced pain and disability they were experiencing ends.
To ensure that you keep up with a routine of exercising, consider joining a group program or bringing a friend or family member along to motivate you.
Eight ways to get started exercising:
Try to choose a type of exercise, or an exercise program, that you enjoy. It will be much easier to stick to the program if you like what you are doing. Most types of activities are helpful for people living with arthritis, so feel free to do your favourite things such as walking, swimming, golfing, or gardening. Exercise doesn’t have to be strenuous or boring to be good for you.
Community centres can be a terrific resource. Flip through the lists of classes offered at your local community or aquatic centre to find activities that best suit your interests and physical abilities.
You may find that having a partner to exercise with will be more motivating. Research tells us that people are more likely to stick with exercises if they bring along a friend or family member.
Sometimes, having a detailed list of activities and realistic goals will help motivate you, so it may be useful to get a referral to a physical therapist to create an appropriate exercise regimen that suits you and your body. Also, keeping an exercise log can help you and your therapist monitor your progress.
For some, assistive devices such as splints or orthotics may be helpful for protecting your joints while you exercise. An occupational therapist can be a good resource.
Before beginning a new exercise program, it is a good idea to speak with your doctor or health care provider to determine the most appropriate exercise or activity for your needs and capabilities. Also, be aware that during flare-ups it is important not to over-stress and over-work joints, which may cause more pain. For this reason it is important to speak to your doctor about exercise and the types of exercises most suitable.
Try setting a firm goal and then rewarding yourself when you achieve it. For example, set a goal of swimming 5 laps. When you reach that goal, reward yourself, and then set a new goal of swimming 10 laps. Rewards can be anything that is meaningful to you: setting aside time for yourself, treating yourself to a massage or a good book, or going out for a meal with friends.
Acknowledge your effort. Be proud of yourself for taking an active role in your health care.
The most recent EULAR recommendations for pain management in inflammatory arthritis and osteoarthritis (OA) include physical activity and exercise as a part of a patient’s treatment plan. Physical activity has been shown to significantly ease joint pain and increase mobility, for this reason, exercise is increasingly being prescribed by physicians and other healthcare providers.
Some examples of well-known and effective exercises for people with arthritis include walking, biking and swimming. These are low-impact aerobic exercises, meaning they will generally be easier on the joints and cause your heart rate to increase. Are there other activities that could also benefit people living with arthritis, such as yoga?
The Canadian Physiotherapy Association describes the profession as “anchored in movement sciences and aims to enhance or restore function of multiple body systems. The profession is committed to health, lifestyle and quality of life. This holistic approach incorporates a broad range of physical and physiological therapeutic interventions and aids”.
Unlike inflammatory arthritis, there are currently no medications to treat the underlying disease process of OA. For this reason, non-medication therapies such as those provided by a physical therapist are important to help slow or stop the progression of OA and help maintain function.
Fitbit’s are wearable devices that individuals can use to track their daily physical activity and increase motivation to do physical activity. Fitbit devices offer real time data on various aspects of daily life including number of steps taken, energy expenditure, time spent asleep, and time spent in different levels of activity. Fitbit devices are becoming increasingly popular in the health-conscious consumer public; they are also being used more frequently in research as measurement tools and to inform healthcare decisions. But are they accurate?
A team of researchers at Arthritis Research Canada and the University of British Columbia, lead by Dr. Lynne Freehan, recently conducted a study to find out how accurate Fitbit devices are as measurement tools. Currently, several devices exist that have been identified as a “research standard” for activity tracking. In this review, researchers measured Fitbit’s accuracy by comparing the readings to that of the research-grade devices.
Arthritis affects people of all ages and can cause stress, and in more serious cases, depression and anxiety. Pain researchers are discovering how emotions, thoughts, and behaviours can influence the level of pain someone experiences and how well they adjust to it. For instance, how an individual responds to stress can predict how well they will recover from hip replacement surgery. Even how a patient feels about whether their coping strategies are working, or not, can affect their experience of the pain itself. Other factors that can influence how well you manage with your disease are whether you feel helpless, tend to spend a lot of time thinking about your pain, whether you decide to accept your pain and carry on in spite of it, and how well you handle stress. Arthritis Broadcast Network believes people living with arthritis deserve extra relaxation on National Relaxation Day and hope that the following tips will help you relax!
Rhythmic breathing and deep breathing can help release tension from everyday life. The former involves inhaling and exhaling slowly while counting to five; the latter can be accomplished by filling your abdomen with air, like inflating and deflating a balloon.
Harvard Health summarizes the benefits of exercise as follows: Exercise reduces levels of the body’s stress hormones, such as adrenaline and cortisol. It also stimulates the production of endorphins, chemicals in the brain that are the body’s natural painkillers and mood elevators. Endorphins are responsible for the “runner’s high” and for the feelings of relaxation and optimism that accompany many hard workouts — or, at least, the hot shower after your exercise is over.Continue reading →
With summer upon us, millions of Canadian youth are participating in sport activities every day. Sport and recreation is a great way for youth to get exercise, socialize, develop teamwork skills and improve mental and physical health. Unfortunately, the benefits of sport also come with the risk of injury. In fact, one in three youth aged 11-18 years will sustain a sport-related injury that requires medical attention each year, with knee and ankle injuries being the most common. Research has shown that these youth sport injuries, if not treated properly, can lead to osteoarthritis (OA) within 15 years, specifically a form known as post-traumatic osteoarthritis. Youth sport injury can also lead to obesity later in life, which happens to be another major risk factor for OA. This means that youth with 1 major risk factor for OA (joint injury) are in danger of acquiring a second risk factor for the disease (obesity).
Osteoarthritis is caused by the breakdown of cartilage in the joints and affects more than 5 million Canadians nation-wide; the disease can cause moderate to severe pain, disability and even require surgery. Osteoarthritis symptoms generally appear 10-15 years after a joint injury, and by this time the disease is very difficult to treat. Unlike inflammatory arthritis, there are no medications to slow the disease process of osteoarthritis, so preventative measures are of even greater importance. The upside? We can ensure our youth take proper precautions to avoid injury and hugely minimize their risk of developing OA.
The benefits of exercise in inflammatory arthritis and osteoarthritis
ACE has frequently written about the benefits of exercise in inflammatory arthritis (IA) and osteoarthritis (OA). During a series of EULAR presentations, speakers provided evidence for regular physical activity for IA and OA patients.
Anne- Kathryn Rausch, an academic from Zurich University, spoke about how general recommendations for physical activity are effective, safe and feasible for patients with ankylosing spondylitis, rheumatoid arthritis, and osteoarthritis. Continue reading →
The research literature on exercise is growing, and it is now generally accepted that there are many benefits of exercise for arthritis and osteoporosis. General benefits of exercise include improved heart and lung function, weight control, and improvement of self-esteem and self-confidence.
Before starting an exercise program, at home or at a gym, it is important to speak to a health professional trained in exercise for arthritis and osteoporosis. They can help you to design an exercise program that will be both safe and effective.
Before, during and after exercise:
It is important to warm-up and cool down before and after exercising. Use range of motion or heat.
If you are still experiencing pain more than two hours after exercise – you may have done too much.
Use slow, planned movements when doing ROM and strengthening exercises.
Practice in front of a mirror until you feel confident you are doing the exercise as demonstrated by your health professional.