159 lines
7.7 KiB
XML
159 lines
7.7 KiB
XML
import Article from "@/components/Article";
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import { Metadata } from "next";
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export const metadata: Metadata = {
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title: "Article - Arthritis and Exercise | Dr. Feely",
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authors: [{ name: "Richard A. Feely, D.O., FAAO, FCA, FAAMA" }],
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description: `In the 1980's the idea of including exercise as part of a
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treatment plan was seen as a radical approach to the management of arthritis.`,
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};
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const ArticleArthritisAndExercise = () => {
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return (
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<Article
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title="Arthritis and Exercise"
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author="Richard A. Feely, D.O., FAAO, FCA, FAAMA"
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>
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<p>
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In the 1980's the idea of including exercise as part of a treatment plan
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was seen as a radical approach to the management of arthritis.
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</p>
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<p>
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Marion Minor, PhD, thought otherwise. In 1989 she conducted a study with
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120 arthritic patients with osteoarthritis and rheumatoid arthritis. The
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patients were randomly assigned to aerobic walking, aerobic aquatics, or
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to a control group of nonaerobic range of motion exercises. The duration
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of the study was for 12 weeks.
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</p>
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<p>
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The results showed that the aquatics and walking exercise groups showed
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significant improvement over the control group in their capacitiy to do
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aerobics, 50-foot walking time, depression, anxiety, and physical
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activity after the 12-week program.
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</p>
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<p>
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“Participants said that they were gaining back control on their lives,
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and not subject to the whim of the disease,” Minor said. “This provides
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a good prototype for self-management and problem-solving, the types of
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things that can further improve the condition of people with arthritis.”
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(1)
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</p>
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<p>
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Around the same time in Denmark researchers were also looking into
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physical training as a way of helping rheumatoid arthritis patients.
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They looked at a graduated exercises going from 2 times per week of
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aerobics and strengthening exercises to eventually progressing to
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strenuous exercises over an 8-week period.
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</p>
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<p>
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The results were encouraging in this study also. The patients had
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significantly fewer swollen joints than before. Exercising the muscles
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of the swollen joints resulted in more than a 35% decrease in the number
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of swollen joints. (2) The Denmark study showed that improving muscle
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strength also improved the affected joint. This was further confirmed in
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other studies.
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</p>
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<p>
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One particular study looked at the effect of strengthening the knee
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muscles of patients with arthritis of the knee joint. In this trial 20
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volunteers with knee joint arthritis were randomly assigned to a
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treatment group (10 people) or to a control group (10 people). The
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treatment group completed six sets of five strong contractions three
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times per week for a period of 8 weeks.
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</p>
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<p>
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At the end of the study the treatment group as compared to the control
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group showed a a significant decrease in pain and stiffness and a
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significant increase in the ability to move. There was also a
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significant decline in the Osteoarthritis Screening Index and the
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Arthritis Impact Measurement Scale. (3)
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</p>
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<p>
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Other areas of exercise therapy for arthritis have also been
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investigated. One such area was to determine whether high or low
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intensity exercises were more effective.
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</p>
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<p>
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100 patients with moderately severe rheumatoid arthritis were randomly
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assigned to (a) intensive group exercises that included full weight
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bearing and also conditioning exercises on a stationary bike; (b) range
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of motion exercises and isometric exercises group; (c) individual
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isometric and range of motion; and (d) home instructions for isometric
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and range of motion exercises. The study ran for 12 weeks.
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</p>
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<p>
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There was about a 17% increase in aerobic capacity strength and joint
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mobility in the high intensity exercise as compared to the other
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exercise groups. When the patients stopped their exercise training
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whatever gains they had achieved in physical capacity disappeared.(4)
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</p>
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<p>
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In a study published in the Journal of the American Medical Association
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researchers looked at whether a structured exercise program would help
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older people with arthritis of the knee. 439 adults, aged 60 or older,
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took part in either an aerobic exercise program, a resistance exercise
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program, and a health education program. 83% of the people completed the
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18 month study.
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</p>
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<p>
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The results showed that the aerobic exercise group had 10% lower scores
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on the physical disability questionnaire, a 12% lower score on the knee
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pain questionnaire, improved performance on the 6-minute walk test, and
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also had improved the time it took to carry 10 pounds as compared to the
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health education group. The resistance exercise group also showed
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improvements but not as good as the aerobic exercise group. (5)
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</p>
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<p>
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Even though exercise is now considered standard treatment for arthritis
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it is not widely prescribed. In a study involving 110 elderly persons
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with chronic hip and knee pain, fewer than half had received the medical
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advice to exercise. Arthritis specialists did much better in prescribing
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exercise than the primary care physician. Further, those patients who
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were told to exercise by their physician were making an attempt to do so
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but only 10% were doing the exercises in a way that would be
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therapeutic. (6)
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</p>
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<p>
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<strong>References:</strong>
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</p>
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<p>
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(1) Efficacy of physical conditioning exercise in patients with
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rheumatoid arthritis and osteoarthritis. Minor MA, Hewett JE, Webel RR,
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Anderson SK, Kay DR. Arthritis Rheum 1989 Nov;32(11):1396-1405
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</p>
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<p>
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(2) The effect of physical training on patients with rheumatoid
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arthritis: changes in disease activity, muscle strength and aerobic
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capacity. A clinically controlled minimized cross-over study. Lyngberg
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K, Danneskiold-Samsoe B, Halskov O. Clin Exp Rheumatol 1988
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Jul;6(3):253-260
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</p>
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<p>
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(3) Effects of muscle-strength training on the functional status of
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patients with osteoarthritis of the knee joint. Schilke JM, Johnson GO,
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Housh TJ, O'Dell JR. Nurs Res 1996 Mar;45(2):68-72
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</p>
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<p>
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(4) Comparison of high and low intensity training in well controlled
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rheumatoid arthritis. Results of a randomised clinical trial. van den
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Ende CH, Hazes JM, le Cessie S, Mulder WJ, Belfor DG, Breedveld FC,
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Dijkmans BA. Ann Rheum Dis 1996 Nov;55(11):798-805
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</p>
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<p>
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(5) A randomized trial comparing aerobic exercise and resistance
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exercise with a health education program in older adults with knee
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osteoarthritis. The Fitness Arthritis and Seniors Trial. Ettinger WH Jr,
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Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T, Shumaker S,
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Berry MJ, O'Toole M, Monu J, Craven T. JAMA 1997 Jan 1;277(1):25-31
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</p>
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<p>
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(6) Joint exercises in elderly persons with symptomatic osteoarthritis
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of the hip or knee. Performance patterns, medical support patterns, and
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the relationship between exercising and medical care. Dexter PA.
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Arthritis Care Res 1992 Mar;5(1):36-41
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</p>
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</Article>
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);
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};
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export default ArticleArthritisAndExercise;
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