Rheumatoid arthritis (RA) is an autoimmune disorder that can impact different body systems and structures including the skin, eyes, lungs, heart and blood vessels. Unlike, osteoarthritis RA is usually symmetrical in clinical presentation affecting joints on both sides of your body at the same time.
Exercise is one of the most effective and potent treatments for those living with rheumatoid arthritis. Physical activity provides numerous benefits by improving your joint health, mobility, psychological well-being and fatigue through improvements in muscle strength and oxygen capacity leading, to reductions in inflammatory mediators.
The current Australian physical activity recommendations suggest that you should aim to complete 150 min/week of moderate intensity exercise or 75 min of vigorous exercise with 2 days of resistance-based activities per week.
Resistance based exercise is a safe and effective way to improve your muscle strength and physical function. Resistance training has been shown to reduce disability, inflammation and cardiovascular risk factors. Exercises should target large muscle groups to improve overall body function and can be undertaken using bands, body weight or weights/machines. Starting at a light intensity is important for the body to become accustomed to exercise and will assist in technique proficiency.
Aerobic exercise when undertaken at a sufficient dosage to achieve health-enhancing effects may elicit beneficial adaptations to your cardiovascular and metabolic systems. Aerobic exercise may also offer protection against common comorbidities such as hypertension and obesity. Aerobic exercise in the forms of cycling, walking, cross-trainer, and rowing are excellent ways to reduce cardiovascular risk factors. Aerobic exercise is safe and can improve measures of disability when undertaken on a frequent and consistent basis, e.g. 30 minutes on most days of the week.
Hydrotherapy when undertaken as adjunctive therapy to medication, has been shown to reduce inflammatory markers compared to medication alone. Hydrotherapy at a moderate intensity can provide cardiovascular improvements with the weightlessness minimising load on the joints. Hydrotherapy should be undertaken in conjunction with a resistance training program to improve muscle and bone health.
Tai Chi is commonly discussed within the arthritis community for balance, strength, and relaxation benefits. For RA there is very low-quality evidence that can neither exclude or confirm positive changes in clinical outcomes, pain or disability.
During a ‘flare-up’ it is typically recommended to rest or alter/modify physical activity in the affected area(s). During the period of a ‘flare-up’ take things a little easier and be mindful of activities that may aggravate the affected area(s). For example, if you find your wrist or fingers affected then it may be recommended to either rest completely or alter your exercise program, e.g., reduced intensity, weight or changing from dumbbells to bands. In this example, if your wrist or fingers are affected it does not mean you can’t exercise lower extremity joints by completing walking, cycling or lower limb weights.
An Accredited Exercise Physiologist will be able to guide you through a ‘flare-up’ to ensure you stay mobile and active.