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Exercise Benefits Rheumatoid
Arthritis Sufferers
Excerpt
by Gary Gately,
HealthDay
Regular, intensive exercise for patients
with rheumatoid arthritis builds muscle strength and aerobic capacity,
improves the ability to do daily tasks and fosters a sense of
emotional well-being.
That's the conclusion of a new
study by Dutch researchers who tracked 300 people with rheumatoid
arthritis (RA) for two years. About half the patients participated
in a one-hour exercise regimen twice weekly; the rest received
traditional treatment, including physical therapy, if prescribed
by their physicians.
The findings, appearing in the
latest issue of Arthritis & Rheumatism, suggest high-intensity
exercise programs can benefit many RA patients, says researcher
Dr. Thea P.M. Vliet Vlieland of Leiden University Medical Center.
"The positive effects on muscle
strength and aerobic capacity could be translated into an improvement
in the activities of daily living, and this is what really makes
a difference in your life," Vlieland says.
Despite the benefits of exercise,
many people with rheumatoid arthritis are wary of strenuous activity.
And physicians often advise patients against intensive exercise,
in part because of fears of damaging large joints and worsening
inflammation, the researchers say.
But the study found that prolonged,
rigorous exercise had no significant detrimental effect on weight-bearing
joints, except in cases of patients who already had considerable
large joint damage.
These patients can still exercise,
but should have individually designed regimens that spare the
damaged joints, says the study, which was led by Dr. Zuzana de
Jong, a rheumatologist at Leiden University Medical Center.
Vlieland stresses that before beginning
an exercise program, all RA patients should receive their doctor's
advice.
Rheumatoid arthritis affects about
2.1 million Americans, mostly women, according to the Arthritis
Foundation. It can cause painful and debilitating inflammation
and deformities in joints and tendons. RA is triggered by an autoimmune
malfunction, and the disease is most often treated with medicines
to reduce the inflammation.
For years, conventional wisdom
in medical circles had suggested that people with RA should not
exercise because doing so could damage joints, the Arthritis Foundation
says. But more recent research has shown exercise is an "essential
tool" in managing arthritis, the foundation says.
The Dutch researchers found almost
all the patients in the exercise group stuck with the program.
Of the 150 patients who started the program, all but 14 attended
exercise classes for the full two years.
"The majority of patients
enjoyed participating in the high-intensity exercise program very
much," Vlieland says.
Indeed, she adds, many of the patients
reported having more physical activity outside of the exercise
program.
Each exercise session consisted
of 20 minutes of bicycling; 20 minutes of exercises to build muscle
strength, endurance and joint mobility; and 20 minutes of sports
such as badminton, volleyball, soccer and basketball. Participants
also had 15 minutes of required warm-up and post-exercise "cool-down."
Participants in both groups --
with a median age of 54 -- had similar RA characteristics. They
were evaluated at the start of the study and every six months
for functional ability, damage to shoulders, elbows, hips, knees
and ankles, and general health and emotional well-being.
The researchers say they found
no significant difference between the two groups in RA symptoms
such as joint swelling or pain or in use of anti-rheumatic drugs
and painkillers.
Compared with patients who did
not exercise, those who did had greater improvement in functional
ability -- from walking up stairs to more complex tasks -- during
both years, the researchers found. Those who exercised also had
significant improvement in physical capacity during the first
year, but the gains leveled off in the second year.
The exercise group also fared better
emotionally, as measured by responses to questions about depressive
feelings and anxiety, the researchers say.
Other experts share the study's
upbeat view of exercise for RA patients.
"Regular exercise is known
to reduce arthritis-related symptoms and improve function,"
says Joan C. Rogers, a professor and chairwoman of the University
of Pittsburgh's Department of Occupational Therapy.
"By keeping up with favorite
activities such as gardening, patients can improve their strength,
range of motion and balance and also relieve stress," she
says.
More information
For more on exercise and arthritis,
visit the Arthritis
Foundation or the University
of Washington Department of Orthopaedics and Sports Medicine.
Reference
Source 101
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