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Can Exercise Help Rheumatoid Arthritis

Tips On Protecting Your Joints

9 Exercises for Rheumatoid Arthritis of the Hands, by Dr. Andrea Furlan

Because RA is an inflammatory condition that affects the joints, it’s usually best to stick with low-impact and joint-friendly exercises to avoid worsening symptoms.

To help protect your joints, check with a healthcare provider first, then:

  • Start gradually:Beginning with 10 minutes a day of light exercise and increasing that amount over time is a good way to introduce your joints to movement.
  • Don’t overdo it:Too much activity can aggravate or worsen symptoms. Listen to your body, and don’t be afraid to modify movements to your abilities that day.
  • Be as consistent as possible: Daily physical movement adds up. Skipping exercise days here or there is fine but a consistent routine is most beneficial to your body and your joints.

What About During A Flare

During a flare it is usually recommended to rest the affected joint. You should still gently move the affected joint as far as is comfortable several times a day as this may help prevent stiffness. However you should not apply any force or resistance to the affected area. For example, if your wrist is affected, do not use any weights or resistance bands with that arm. If you are feeling otherwise well, you can still do some gentle exercise for the rest of your body. Talk to your rheumatologist or physiotherapist for more information.

Data Analysis And Synthesis

Tables and forest plots were produced to tabulate and visually display the results of the individual studies and syntheses. RevMan5.3 software was used for statistical analysis. Since the measure of dispersion for change was not always available, we imputed a change-from-baseline standard deviation using a correlation coefficient as recommended by the Cochrane Handbook . The measurement data used the mean difference or standard mean difference as the effect analysis statistics, and each effect size provided a 95% CI. The heterogeneity among the results of the included studies was analysed by 2 tests , and the degree of heterogeneity was quantitatively judged by combining with I2. Given I2< 50% and p> 0.1, a fixed-effects model was used for analysis if I2> 50% and p< 0.1, a random-effects model was applied. The level of meta-analysis was set to =0.05. In addition, subgroup analysis was adopted. Two subgroups, short-term and long-term , were divided according to the length of the intervention.

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A Discussion With Prof George Metsios

Watch our very popular Rheum Zoom from May 2021 including Q& A session and short Exercise video with Ayesha Ahmad on resistance training.

Why should I exercise?

Physical activity and exercise are good for people with all forms of arthritis as it can help to ease some of the symptoms and improve general health. There is quite a lot of evidence now that exercise can improve muscle strength, function and the ability to do everyday things as well as reduce the risk of cardiovascular disease.

Diagram produced on behalf of people with arthritis. Reproduced with permission Sue Gurden, Aneurin Bevan Health Board

New technologies in modern society have led to more sedentary occupations and lifestyles. Unfortunately, many people with inflammatory or rheumatoid arthritis, like the general population, arent active enough. People with rheumatoid arthritis might be worried that exercise will make RA and its symptoms, such as pain, worse. This is not the case, and studies evaluating exercise programmes have shown that exercise does not make your arthritis worse. Clinical guidelines recommend that people with rheumatoid arthritis should improve general fitness and be encouraged to complete regular exercise including exercises for enhancing joint flexibility, muscle strength and managing other functional problems.

Who can help me to become and stay more active and to exercise?

How much and what types of exercise should I do?

There are different types of exercises:

Activity levels

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As part of a well-rounded treatment strategy, it is important to include exercise for rheumatoid arthritis . Though it may seem difficult or challenging to exercise, especially when dealing with chronic pain, physical activity is necessary to increase joint function, strengthen muscles, and improve overall health and energy levels.

While exercise is very important in RA treatment regimens, there are a few risks. Be sure to practice safe exercises and combine them with stretching and strength building activities for better physical health.

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Benefits Of Exercise For Ra

There are some important benefits of developing a consistent and balanced exercise plan for RA. Here are some of the top benefits of exercise for RA:

  • Improve emotional and mental well-being
  • Decrease levels of depression

Just as patients take specialized medications regularly, so too should they exercise regularly to improve health and fight against disease symptoms. They should think of their exercise program as just another medication in their treatment arsenal!

Whats Ok For Me To Do

If you donât already exercise, check with your doctor first. Tell them what you want to do, and ask what types of things will be best for you and what you should avoid.

Your exercise plan will probably include low-impact activities such as:

  • Using an elliptical machine

Any of these will get your heart pumping. Youâll hear this called cardio or aerobic exercise. Picking something you enjoy will help you succeed.

Strength training uses resistance to work your muscles. You can use machines at a gym, hand-held weights, resistance bands, or even your own body weight. This makes muscles stronger and increases the amount of activity you can do.

Itâll take time to get stronger. Make your strength training workouts harder over time. Do them every other day if you can. If you’re new to weightlifting, book a few sessions with a physical therapist or a trainer for pointers.

You can also do stretching exercises, but they should be gentle. Never stretch a muscle thatâs not warmed up. Ask your physical therapist how and when you should stretch.

After your doctor gives the OK, try to do 20 to 30 minutes of low-impact conditioning exercise on as many days as you feel up to it. Remember, some exercise is better than none!

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Perceptions Of Ra Patients Regarding Exercise

Whilst there are numerous reasons why exercise is considered to be of fundamental benefit, it is apparent that the RA population is less physically active than the general population. Therefore, it is important for those involved in the care of RA patients to be aware of factors that may positively and negatively affect the uptake of and compliance to an exercise prescription.

The perceptions of people with RA may provide reasoning for the lower physical activity levels of RA patients when compared to the general population . Thus, understanding the perceptions of RA patients regarding exercise is salient to the role of the health professional .

A further issue relating to the health professional is their own assertion and certainty when prescribing exercise to those with RA. In the study by Iversen et al. , only 51% of rheumatologists reported they felt confident that they knew when exercises were appropriate for their patients with RA. Correspondingly, recent research has revealed that patients perceive uncertainties within the health profession regarding the impact of exercise on pain and joint health. In particular, this was in relation to whether the sensation of exercise discomfort or pain equated to actual joint damage and the effects of different types of exercise on the health of their joints . These concerns pose a further challenge to RA patients .

What Do Studies Tell Us About The Benefits Of Exercise

Rheumatoid Arthritis Hand Exercises | Mobility & Strength

The benefits of exercise for patients with RA have been demonstrated in a variety of well-controlled studies.1-4

One study evaluated the benefits of a regular program of strength training combined with aerobic activity for patients with early RA.2 The study found that over a two-year period a regular strength training and aerobic exercise program resulted in significant improvements in muscle strength and physical functioning, without any negative effects on disease activity.

Compared to a control group , the group that combined strength training and aerobic activity had greater improvements in muscle strength, disease activity, and physical functioning, as well as significant improvements in bone mineral density measurements.

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Flowing Movements Such As Tai Chi And Yoga

Both tai chi and yoga combine deep breathing, flowing movements, gentle poses, and meditation. They increase flexibility, balance, and range of motion while also reducing stress.

A of participants with RA who had done group tai chi suggested that tai chi could reduce anxiety and depression while increasing self-motivation and self-esteem.

The participants did tai chi twice a week for 12 weeks.

A 2013 study of women with RA who did Iyengar yoga suggests that this exercise had mood, fatigue, and pain disability benefits. The participants did yoga twice a week for six weeks.

It is possible to find free online videos or apps like Gaia for tai chi or yoga workouts, including some yoga workouts specifically for people with RA. A person should always talk to their doctor before starting a yoga or tai chi practice.

Can Exercise Help My Rheumatoid Arthritis

Exercise can help people with rheumatoid arthritis . There are a few studies done by doctors to see how exercise affects people with RA. The results show that exercise can have many health benefits.

Exercise can help people with RA:

  • Do day-to-day activitiesmore easily. Doctors use a list of questions to ask how hard it is for you to walk, get dressed, and do other everyday activities. Each question has a score. A higher score means that its harder for you to do those activities. In one study, the scores of people with RA greatly decreased after 6 months of exercise! Other studies have shown that people were able to walk faster and had stronger hand strength.
  • Feel less tired
  • Feel less joint pain
  • Feel less anxious or depressed
  • Gain muscle and lose fat. Gaining muscle improves strength. This makes it easier to do day-to-day activities, such as walking or getting dressed.

Experts say you should exercise 150 to 300 minutes per week. For example, exercise for at least 30 minutes for 5 times a week. But any activity is better than none. These health benefits can be seen even if you dont exercise the suggested amount every week. Sometimes it takes time to work up to the recommended amount of exercise. Also, check with your doctor before starting a new or higher intensity exercise program. Some exercises may not be right for you. Your doctor can help you find the right ones for you.

Exercise can be the way to brighten up your day!

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Exercising For Rheumatoid Arthritis Relief

In addition to medication, exercise is one of best treatments for rheumatoid arthritis. This may be frustrating to hear, since RA joint pain and fatigue can make physical activity seem unappealing. It can help to understand how physical activity helps reduce RA symptoms and how to exercise safely.

This article discusses how exercise helps treat RA1,2 and describes specific exercises to try.

Rheumatoid arthritis can occur in joints throughout the body, such as the knees, ankles, hips, elbows, and shoulders. Watch:Rheumatoid Arthritis Overview Video

Work With A Physical Therapist

Rheumatoid Arthritis Hand Exercises That Can Help

Working with a physical therapist who specializes in RA can be helpful in developing a safe and appropriate exercise routine. This collaboration can be particularly beneficial for people with a new RA diagnosis or those who are experiencing a severe flare.

may include high-impact exercises that put excessive strain on the joints.

However, there are no specific exercises that everyone with RA should avoid. Each person is different, and an activity that causes pain for one person may not have the same effect on another person.

What is suitable for someone will depend on their situation and health condition. However, everyone is likely to benefit from paying close attention to their body and working with a doctor or physical therapist for guidance, if possible.

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How To Create An Exercise Plan

The best exercise program is one that you enjoy doing. First, discuss exercise goals with a healthcare provider. Next, take a closer look at exercise options and plan out the activities that you’d like to try.

Here are the weekly exercise guidelines recommended by the CDC for most adults with RA and other forms of arthritis:

  • 150 minutes of moderate-intensity aerobic exercise: This might include a water aerobics class, biking on ground level, or taking a brisk walk.
  • 75 minutes of vigorous-intensity aerobic exercise: Examples include swimming laps, biking on a hilly terrain, or playing tennis.

For beginners, this may mean starting out with two 10-minute exercise sessions per week, then building up to five 30-minute sessions weekly. If this seems daunting, just focus on being as active as you can. Getting some physical activity in is better than getting none.

Don’t forget that daily activities can count toward your movement goals.

Types Of Exercise For Ra

Those with RA can still perform regular physical activities and even play certain sports. Depending on the disease stage, many RA patients continue to stick to their regular exercise routines or modify them to protect joints from stress and further damage.

Some common and recommended exercises for RA include :

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Benefits Of Regular Exercise For Patients With Ra

  • Improved muscle strength and function
  • Improved joint stability
  • Increased quality of life
  • Improved bone health

Regular aerobic exercise has been shown to improve muscle function, the stability of joints, endurance, and physical functioning and performance.

Additionally, aerobic exercise can result in improvements in pain control and overall quality of life for patients with RA.2-4 Weight training or resistance training may be particularly important because they have been shown to be useful in preventing bone loss which can result from the RA disease process as well as from long-term glucocorticoid treatment.1

How To Protect Your Joints During Exercise

7 Helpful Hand Exercises for Rheumatoid Arthritis: A Beginner Hand Workout

While exercise can help you function better on a daily basis and prevent muscles from atrophying, your exercise choices have to be specific to maintaining joint integrity and pain management, according to the American College of Sports Medicine.

Try making these simple adjustments:

  • Choose low-impact exercises that dont stress the joints, such as walking, biking, or swimming.
  • Condition muscles properly before you challenge yourself in your workouts.
  • Work out for a shorter time and at a lesser intensity when youre having a flare-up or experiencing pain and swelling.
  • Exercise in several short bursts throughout the day rather than doing one long workout session.
  • Create a routine that combines aerobic activity and resistance exercises that build muscle to help you avoid an overuse injury.
  • Warm up properly before you exercise.
  • Cool down afterward.
  • Add flexibility exercises to your routine to help increase range of motion.
  • Wear good athletic shoes that offer shock absorption and support your feet.
  • Try water therapy, such as walking in a pool, when your RA is very active, if youre having a flare, or if your RA is severe.
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    Exercise Can Ease Rheumatoid Arthritis Pain

    Rheumatoid arthritis can cause pain and stiffness that makes moving the last thing you want to do.

    But staying active is important. Not only is it beneficial for your general health it’s also a way to strengthen your joints, improve your range of motion, and give you the opportunity to take part in the activities you enjoy.

    For people with RA, it’s best to take a cautious and strategic approach when starting an exercise program. An individualized program ideally developed with the help of a physical therapist can help you protect vulnerable joints while strengthening surrounding muscles. A well-rounded exercise program should include each of these elements:

    Aerobic conditioning. Exercise that increases your heart rate and breathing rate has many benefits, including lowering your chances of developing conditions such as diabetes, stroke, and heart disease. It’s especially important for people with rheumatoid arthritis because they are more prone to developing heart disease than people without RA. When choosing aerobic activities, people with rheumatoid arthritis should consider low-impact exercises such as swimming, bicycle riding, and walking.

    Stretching and flexibility exercises. Joints damaged by rheumatoid arthritis don’t move with the same ease or to the same degree as healthy joints. That makes activities that lengthen and strengthen the muscles surrounding your joints, such as stretching exercises, tai chi, and yoga, especially important for people with RA.

    British Columbia Specific Information

    Being physically active can benefit your physical and mental health in many ways. It can strengthen your muscles and bones, lower your risk of chronic health conditions, and improve your mood and sleep. Physical activity can be safe for almost everyone. If you have concerns about your health or becoming more active, talk with your health care provider or a qualified exercise professional.

    For information and resources on physical activity for general health and arthritis, visit the general health and arthritis sections of our website. If you would like guidance on physical activity or exercise, call our qualified exercise professionals by dialing 8-1-1 and asking to speak with Physical Activity Services between 9:00 AM and 5:00 PM Pacific Time Monday to Friday. You can also leave a message outside of these hours and email a qualified exercise professional.

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    Assessing Readiness To Exercise

    Psychological readiness to begin exercising is also an important consideration. Theories of behavior change suggest that people vary widely in their readiness to adopt new behaviors. Up to 40% of individuals may be in the precontemplative stage where they remain essentially unaware of the problem and have not yet thought about change. For these individuals, realistic goals for exercise counseling are to increase awareness of the importance of physical activity and to personalize information about the benefits that can be anticipated.

    For those who express a willingness to be more active, a medical history and physical exam is advised. Specifically, the evaluation should assess the severity and extent of joint involvement, overall level of cardiovascular conditioning and presence of other comorbid conditions.

    In the book titled ACSMs Exercise Management for Persons with Chronic Diseases and Disabilities, The American College of Sports Medicine recommends the following exercise testing program for individuals with arthritis:

    • Muscle strength and endurance
    • Joint flexibility and range of motion
    • Neuromuscular fitness, including gait analysis and need for orthotics
    • Functional capacity to accomplish activities of daily living

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