Rheumatoid Arthritis (RA) Awareness Week aims to raise awareness of the condition and provide education to inform those who have RA or are interested to know more about the condition and how it affects their friend, loved one or even colleague (1).
What is Rheumatoid Arthritis?
RA is commonly confused with osteoarthritis (OA). However, RA can affect anyone from the age of 16, compared to OA which is commonly diagnosed in older adults. RA is a systemic, autoimmune disease, and the most common form of chronic joint inflammation (2). A major characteristic of this condition is severe inflammation of the synovium, which is the membrane that lines our joints. Unfortunately, previous research has been unable to pinpoint the cause of this condition. However, there has been evidence suggesting that people can be genetically predisposed, meaning that they are at higher risk of a diagnosis as well as the influence of environmental factors such as smoking (3).
RA is also known to affect the organs of one’s body including skin, heart, kidneys and lungs (4). As a result, people with RA have an increased risk of developing cardiovascular disease. People diagnosed with RA can also experience an accelerated loss of muscle mass, known as ‘rheumatoid cachexia’ (2). These effects on the body contribute to a greater level of disability and can have a significant impact on an individuals’ quality of life (2). This is where an Exercise Physiologist can help!
Exercise Benefits for Rheumatoid Arthritis
There has been extensive research on exercise and the benefits involved for people with RA. Below are some research articles that support exercise and physical activity for people diagnosed with RA.
Article 1: Benefits of Exercise in Rheumatoid Arthritis – Journal of Aging Research (2)
Recommendations from the American College of Sports Medicine (ACSM) suggest for that everyone should accumulate at least 30 minutes of moderate-intensity physical activity on most days of the week (2). ACSM have also issued another set of guidelines for older adults and adults with conditions such as RA. These guidelines are similar with an additional focus on muscle strengthening exercises and exercises to improve balance and flexibility (2).
Exercise has been shown to have specific health benefits in people with RA. The reported benefits of adequately designed exercise programs include improved cardiorespiratory fitness and cardiovascular health, increased muscle mass, reduced adiposity, improved strength, and physical functioning, all achieved without exacerbation of disease activity or joint damage (2).
High intensity resistance exercise has been shown to safely reverse cachexia (loss of muscle mass) in patients with RA which resulted in a substantially improved physical function and reduced disability in RA patients (2).
It has been proven in this research article that high-intensity progressive resistance training performed by RA patients, both newly diagnosed and long-standing experience and increase in muscle mass, strength, and improved physical function, whilst being well tolerated and safe (2). It is advocated that such programs are included in condition management to counteract the effects rheumatoid cachexia. Graded resistance training can also benefit other health aspects, including improved coordination and balance which has been shown to be affected by RA (2).
Article 2: Rheumatoid Arthritis: A Brief Overview of the Treatment (4)
Along with RA-specific medications, potential surgical interventions and other treatment, patients with RA also benefit from physical therapy. It is recommended that exercise is performed regularly to maintain or even improve joint mobility and strengthen the muscles surrounding the affected joints (4). Physical activity that are low impact but promote muscular strength and joint health include:
- Swimming
- Yoga
- Tai chi
Article 3: Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation (5)
Physical activity interventions have been found effective at improving both systemic and disease-related manifestations in RA and reducing the overall cost that can be accompanied with the disease specifically replicated through reductions of hospital admissions and days of hospitalisation (5).
Randomised and controlled clinical trials have demonstrated significant reductions in radiological damage in joints as a direct result of increases in physical activity participation alongside significant improvements in cardiovascular fitness, strength and functional ability (5).
Engagement in various types of exercise including high-intensity exercise has been found safe to complete in RA; in contrast, a sedentary lifestyle in RA can additionally promote increased risk for development of CVD (5). Unfortunately, despite cumulative evidence about the methods and beneficial effects of increasing physical activity levels in RA patients they are not incorporated in routine clinical care consequently, RA patients remain sedentary with physical activity levels well below those recommended (5).
Article 4: Clinical effect and biological mechanism of exercise for rheumatoid arthritis: A mini review (6)
Current literature suggests exercise interventions greater than 12 weeks have been found effective at alleviating pain, improving physical ability, aerobic function, quality of life, mental health, sleep status and fatigue in patients with RA (6).
Further, longer periods of exercise may reduce RA disease activity through the following mechanism’s immune cells and immunity, inflammatory response, inflammatory factors, epigenetic expression and oxidative stress (6).
Specifically moderate to high intensity exercise including strength and aerobic exercise were the most effective in reducing disease activity and safe for patients with RA (6).
What can an Exercise Physiologist do?
Physical activity and exercise has been proven to be safe and provides a number of benefits for our overall health and wellbeing. If you or someone you know has RA and is unsure whether they should commence or continue with exercise and physical activity with their current symptoms or conditions, chat to us! Exercise Physiologists have the knowledge and expertise to provide a tailored exercise program or physical activity plan to suit people of all backgrounds and ages to support their physical and social wellbeing.
Want to talk to one of our team and find out how we can support you and your goals? Contact us today!
References:
- National Rheumatoid Arthritis Society, click here for more information.
- Benefits of Exercise in Rheumatoid Arthritis, National Library of Medicine, click here for more information.
- NHS, click here for more information.
- Rheumatoid Arthritis: A Brief Overview of the Treatment, National Library of Medicine, click here for more information.
- Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation, Best Practice & Research Clinical Rheumatology, click here for more information.
- Clinical effect and biological mechanism of exercise for rheumatoid arthritis: A mini review, National Library of Medicine, click here for more information.
Written by Uplift Exercise Physiologist, Molly Cushan
