RESEARCH - Rheumatologists urged to get arthritics moving

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Rheumatologists urged to get arthritics moving

Rheumawire

April 20, 2006

Janis

Los Angeles, CA - Strength training and aerobic exercise benefit people with

osteoarthritis (OA) or rheumatoid arthritis (RA), but surprisingly few

arthritis patients are incorporating reasonable levels of physical activity

into their daily lives, reports Dr Margaret Shih (Los Angeles County

Department of Health Services, CA) [1]. In an analysis of data from the 2002

National Health Interview Survey, Shih and colleagues write in the May 2006

issue of the American Journal of Preventive Medicine that more than one

third of adults with arthritis were inactive and the rest were significantly

less likely than nonarthritics to engage in recommended levels of moderate

or vigorous activity.

" The most notable finding was that 37% of adults with arthritis do not

engage in any leisure-time physical activity, despite the known benefits of

physical activity. One question it raised is how do we get people with

arthritis more involved in regular physical activity, especially women, the

elderly, and racial/ethnic minorities, and also how can we increase

adherence to exercise programs, " Shih told rheumawire.

Counseling, pain management, treatment of comorbid anxiety/depression might

help Shih and colleagues estimated the proportion of adults with arthritis

who met four physical-activity recommendations from the Healthy People

2010(HP2010) initiative and one arthritis-specific recommendation. The four

general recommendations were engaging in some regular leisure-time physical

activity; 30 minutes per day of moderate activity; 20 minutes of vigorous

physical activity on at least three days per week; and exercise that

promotes strength and endurance. The arthritis-specific activity was 30

minutes of moderate-intensity physical activity at least three days a week.

" Patients with arthritis are not getting enough physical activity, even

though moderate-intensity physical activity is safe for most patients with

arthritis who do not have severe functional limitations. Physical activity

can decrease arthritis-related pain, improve physical functioning, and delay

disability in patients with arthritis. Clinicians should provide

physical-activity counseling in conjunction with pain-management measures

when treating patients with arthritis. Clinicians should be aware of the

availability of evidence-based interventions such as the Arthritis Self-Help

Course, the Arthritis Foundation Exercise Program (formerly known as 'People

with Arthritis Can Exercise'), and the Arthritis Foundation Aquatics

Program, " Shih said.

Adults with arthritis were not significantly less likely than nonarthritics

to report inactivity (37% arthritis, 38% no arthritis), to participate in

strengthening exercise (20% both), or to meet the arthritis-specific

recommendation (37% arthritis vs 39% no arthritis). Adults with arthritis

were significantly less likely to meet the recommended levels for

moderate/vigorous exercise (30% vs 33%, p=0.05) or vigorous activity (21% vs

24%, p=0.006). Patients with four or more functional limitations, one or

more social/leisure limitations, a need for special equipment, or who lacked

access to a fitness facility were most likely to report inactivity, as were

those with frequent anxiety or depression.

" Rheumatologists should ask their arthritis patients directly whether or not

they are physically active and what type of activities they are involved in,

so they can engage their patients in a discussion of the importance of

physical activity and what types of exercise might be most appropriate for

individual patients. It would also be an opportunity to address any concerns

the patient might have about starting an exercise program (eg, concerns

about worsened pain or potential damage to joints) and to connect them to

local self-management or exercise programs, " Shih said.

The authors also point to " the need for healthcare providers to counsel on

physical activity, to manage pain adequately, and to recognize the risk from

comorbid mental-health disorders. "

Source

1. Shih M, Hootman JM, Kruger J, et al. Physical activity in

men and women with arthritis. National Health Interview Survey, 2002. Am J

Prev Med 2006; 30:385-393.

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I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org