Arthritis is a condition affecting the synovial joint and is characterized by inflammation, varying degrees of degeneration of joint structures, and pain. Finding the correct balance of rest and physical activity in the comprehensive management of arthritis is a challenge. Despite traditional beliefs that individuals with arthritis should avoid vigorous physical activity, regular physical activity reduces impairment and improves joint function without aggravating symptoms (8).
Arthritis and rheumatoid disease are among the most prevalent chronic conditions in the United States, affecting an estimated 43 million persons in 2000 (one in seven) and a projected 60 million by 2020, according to the Centers for Disease Control and Prevention (2, 7). Women are affected by arthritis more than men- nearly two thirds of people with arthritis are women. Arthritis is the number one cause of disability in America, and it limits everyday activities such as dressing, climbing stairs, getting in and out of bed, or walking.
Arthritis and rheumatoid disease cause muscle weakness, fatigue, and pain, stiffness, and swelling in joints and other supporting structures of the body such as muscles, tendons, ligaments, and bones. The two most common conditions of arthritis and rheumatic diseases are osteoarthritis and rheumatoid arthritis. Osteoarthritis is a degenerative joint disease that typically impacts the knees, hips, feet, spine, and hands. Rheumatoid arthritis is a chronic, systemic inflammatory disease affecting the synovial membrane of joints. The complications of arthritis may lead to a less active lifestyle. However, individuals with either inflammatory or degenerative joint disease generally are able to engage in regular exercise to improve their health status. The goals for many arthritis patients are to engage in normal everyday activities without undue fatigue and pain, improve cardiovascular, muscular, and flexibility fitness, enhance functional status, and decrease joint swelling and pain.
Arthritis And Exercise
In the past, doctors often advised arthritis patients to rest and avoid exercise (1, 5). Rest remains important, especially during flares, but inactivity can lead to weak muscles, stiff joints, reduced joint range of motion, and decreased energy and vitality.
Studies have consistently shown that people with arthritis have weaker muscles, less joint flexibility and range of motion, and lower aerobic capacity, compared to those without arthritis (5). In addition, individuals with arthritis have been found to be at higher risk for several other chronic diseases, including coronary heart disease, diabetes mellitus, and osteoporosis. Thus, it makes sense that a well-rounded physical fitness program may be of benefit to those suffering from arthritis.
Individuals with arthritis will often respond to their pain by limiting their physical activity (3). Over time, this leads to loss of muscle strength and endurance, which further weakens the joints and sets up a vicious cycle that accelerates arthritis.
There are many potential benefits of exercise for the individual with arthritis (1, 5):
- Improvement in joint function and range of motion
- Increase in muscular strength and aerobic fitness to enhance activities of daily living
- Elevation of psychological mood state
- Decrease in loss of bone mass
- Decrease in risk of heart disease, diabetes, hypertension, and other chronic diseases
Can regular exercise improve, retard the progression of, or even cure arthritis? While exercise for people with arthritis is important for all the aforementioned reasons, investigators have typically found that exercise training does not improve arthritis, but neither does it worsen the disease process. In other words, exercise does not affect the underlying disease state in people with arthritis one way or the other, but it does improve many other areas of importance to life quality (4, 6, 9).
In one study, researchers randomly divided 102 patients with osteoarthritis of the knee into walking and control groups (6). Those in the walking group walked up to 30 minutes, three times a week, for 8 weeks. The walkers experienced a strong increase in their performance during a 6-minute walking test, an effect that was achieved without exacerbating pain or triggering flares. In other words, those with osteoarthritis became fitter with the exercise program, but their disease was neither reversed nor progressed.
In the 18-month FAST (Fitness Arthritis and Seniors Trial) study, 439 adults age 60 years or older, with osteoarthritis, were randomly divided into one of three groups: (1) health education (no exercise), (2) aerobic exercise (three 40-minute sessions per week), or (3) resistance exercise (three 40-minute sessions per week, with two sets of 12 repetitions of nine exercises) (4). The mean score on the physical disability questionnaire was significantly improved for both exercise groups. Other tests revealed lower pain scores and improved measures of performance with exercise. The researchers concluded that older disabled persons with osteoarthritis of the knee can experience improvements in measures of disability, physical performance, and pain as a result of participating in a regular exercise program.
Other researchers have come to the same conclusions: Patients with arthritis are trainable (i.e they can get stronger and more aerobically fit), and the exercise can be done safely without detrimental effects on the joints (4, 6, 9). However, the results show no effect of training on the disease activity or the progression of the disease.
If you have Arthritis, learn about how Arthritis is a chronic disease which is eligible to receive a Medicare Rebate when seeing an Accredited Exercise Physiologist:
Did you know you could get up to 50% off with a Medicare Rebate?
Learn how an Accredited Exercise Physiologist can help you to begin and maintain exercise in your life, so you can enjoy the health benefits of Exercise for Arthritis:
What Does an Exercise Physiologist Do?