Exercise is Part of a Healthy Lifestyle for Rheumatoid Arthritis

Patient Expert

Less than 15% of people with rheumatoid arthritis exercise 3 or more times a week

That uninspiring statistic comes from a recent international study of the exercise habits of people with rheumatoid arthritis. Even more alarming, the study found that about 70% of people with rheumatoid arthritis perform no regular physical activity.

So what's holding us back? Is it lack of time? Lack of access to activities? Pain and inflammation? Or is it fear?

Myth: Exercise impedes Joint Pain Relief

For decades, it was thought that physical activity would increase rheumatoid arthritis disease activity and cause or accelerate joint damage. Exercise plans were very conservative and aimed at pain relief or increasing range of motion. But recently, accepted thought has shifted. America is on a health kick, targeting our fast-paced lifestyles and unhealthy eating habits. Many articles extol the virtues of regular physical activity, especially for people with rheumatoid arthritis. Exercise is associated with better physical and mental health, decreased cardiovascular risk, better flexibility and mobility and healthier weight. Additionally, for people with rheumatoid arthritis, moderate exercise is now thought to decrease inflammation and pain and improve function. Twenty-five years ago, when I was begging to join my school T-ball and soccer teams, my rheumatologist refused to sanction it. Now, children with rheumatoid arthritis are encouraged to play sports (always keeping their capabilities and limitation in mind).

**Rheumatoid Arthritis and joint pain helped by exercise  **

But for all the recent attention to diet and fitness in schools, communities and in the national media, studies still show that many people with rheumatoid arthritis are still inactive. This international study, published in the January issue of Arthritis Care & Research compared 2005 through April 2007 survey data from rheumatology clinics in 21 countries. Most of the countries were European, but the U.S., Canada and Argentina were also included. Of the 5,235 subjects, most were white women and the average age was 57 years old. Factors associated with physical inactivity were similar to factors found in several other studies: female gender, older age, lower education, obesity, other diseases, low functional ability, increased disease activity, pain and fatigue.

The most physically active subjects were from Finland, where 32% exercise 3 or more times per week, 39% exercise 1 or 2 times per week, and only 29% do not exercise. Argentina had the least active participants, with 88% having no physical activity. While the American subjects weren't the least active, the data wasn't encouraging. Almost 70% of the U.S. subjects in the study had no physical activity, while 14% exercise 1 to 2 times per week and 17% exercise 3 or more times per week. This data is somewhat disheartening for me because activity levels are so much lower than those reported in a U.S. study that I wrote about in 2006. http://www.healthcentral.com/rheumatoid-arthritis/c/38/1592/adults/ That study, reported in the May 2006 issue of the American Journal of Preventive Medicine, found that just over a third of adults with arthritis are inactive. This statistic isn't good, by any means, but it's more optimistic than the 70% from this recent study. The study methods and surveys used were different, so perhaps that accounts for the dramatic difference.

The researchers in the international study noted that some countries had much smaller sample sizes than others. Also, since most of the subjects were white women in their mid-50's, they noted that other demographic groups might have different activity levels and that more research is needed. The researchers also concluded that more research is needed to identify ways to motivate people with rheumatoid arthritis to increase physical activity levels. Also, counseling by physical therapy or health educators and referrals to community-based resources should be included in routine rheumatology care.