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Exercise
Benefits Rheumatoid Arthritis Sufferers
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.
For more on exercise and arthritis, visit the Arthritis
Society or the University
of Washington Department of Orthopaedics and Sports Medicine.
Article Source: HealthDay
Article Author: Gary Gately
Net Reference 101
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