Arthritis: how sufferers can still regularly exercise

Cautious exercise can be beneficial for arthritis sufferers

Doctors often recommend rest and avoidance of exercise for arthritis patients. Yet, while rest is important during flares, lack of exercise only leads to loss of strength, loss of CV fitness and reduced range of motion and coordination. Consequently, David Nieman in a new study recommends a combination of activity and rest, customised to suit the individual patient.

Arthritis patients should be assessed before commencing an exercise programme. Muscle function can be tested on an isokinetic machine within a pain-free range of motion. CV fitness can be assessed with a sub-max test on a bike or with a walking test, such as the mile-walk time. Joint flexibility should be assessed in all joints with a goniometer. Function tests such as gait analysis and ability to stand up from a seated position should also be recorded. The results from the assessments can be used to monitor the efficacy of the programme you design.

The exercise programme should try to achieve the following three main goals:

1. To preserve or improve range of joint motion.
2. To increase strength to enhance stability.
3. To increase CV fitness to improve health and reduce disease risks.

The most time should be spent on flexibility and mobility exercises. Nieman recommends both static stretches and active range of motion exercises for the affected joints. The range of motion should be gentle and the patient encouraged to perform the exercises little and often, every day.

Isometric exercises can be used to build strength in a safe and pain-free way. When strength has been developed with this approach, limited-range dynamic exercises can be used. Two strength sessions per week are recommended, using moderate intensity and repetitions.

CV fitness is best developed using low-impact activities, such as walking, swimming, aquatic exercises and cycling. Starting with 10-15 minutes per day, or two or three shorter bursts spread over the day, patients can build up to 30+ minutes of moderate CV exercise 3-5 times a week. Orthotics and quality training shoes may be required for some patients.

Obviously there can be complications with arthritis patients and regular exercise. For example, pain and stiffness post-exercise and repetitive impacts may be risk factors. However, the benefits of maintaining range of motion and strength to facilitate normal life as best as possible and CV fitness to prevent obesity and disease risks should encourages trainers and therapists to encourage arthritis victims to become more active.

(David Nieman, 'Exercise is good for arthritis.' Health and Fitness Journal, 4(3), 2000.)

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