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