Rheumatoid arthritis is a chronic inflammatory disease where the immune system starts attack the healthy tissue lining of the joints. It is commonly presented in the fingers, wrists, feet and ankles and can cause painful deformities and immobility. This leads to muscle loss and weakness, which in turn results in a significant reduction of physical activity and aerobic capacity, also heightening the risk of other associated comorbidities.
Currently the direct cause of this dysfunction of the immune system is unknown but the main risk factors towards developing RA is smoking and family history. While there is no cure for RA there is a number of effective maintenance therapies either through the use of medicine or physical therapy.
Exercise therapy has been consistently been shown in recent studies to have a key role in managing those with RA, studies showing that exercise reverses the negative effects that the disease has on the muscle, improves function and decreases disability as seen at The Physio Movement.
Previous exercise regimes were more conservative focusing more towards isometric strengthening programs but recent literature review showed that incorporating both an aerobic training or high impact activity did not increase disease activity nor cause any long-term structural damage and was more an effective intervention for disease maintenance.
While exercise has been shown to be of great benefit and it is found to be safe for people with RA is it important that you get the correct information from an allied health professional.
Couple of quick pointers to help those with RA
- During a flare-up, rest joint as there is increased risk of damage
- Avoid uncomfortable / poor posture and positions during activity
- During flare-ups avoid stretching or excessive bending
- Do activity within pain levels (generally considered pain within a pain increase of 1-2/10)
- Have correct work to rest ratio to help avoid significant fatigue
- Try and use larger muscles / joints during activity’s i.e loading through the legs when picking something off ground or bending over
- Resume exercise regime slowly once flare-up is gone
The following guidelines is a rough example of an exercise regime recommended for people with RA
Strength training & aerobic training for <1 hour per day, recommended to do exercise in smaller blocks throughout the day
Aerobic component of 50-70% Maximum predicated HR
Strength component 70% of maximum rep
exercise frequency of ~2-3 times a week
