By Dr. Leigh Callahan, UNC Health Care An essential component of a healthy life is physical activity. It has been shown that people who exercise regularly live longer and are healthier than people who are sedentary. Benefits include improved fitness, greater psychological health, prevention of cardiovascular disease and a reduction in all-cause mortality. The importance of physical activity in preventing a number of chronic diseases is highlighted in the 1996 Surgeon General’s report on physical activity and health.
It has been demonstrated that regular moderate-intensity physical activity improves symptoms and functional status in individuals with arthritis. Despite the demonstrated benefits of physical activity, more than 60 percent of adults with arthritis do not meet the U.S. Surgeon General’s recommendations for physical activity. Individuals with arthritis report substantially higher rates of no physical activity during leisure time compared to individuals without arthritis, independent of the presence of disability.
Almost 32 percent of individuals with nondisabling arthritis and 47.4 percent of those with disabling arthritis report no physical activity during leisure time compared to only 26.4 percent of individuals without arthritis and without disability. Individuals with arthritis also report lower rates of regular vigorous leisure time physical activity.
Arthritis often leads to increased inactivity, which results in reduced joint mobility, strength, fitness, exercise participation, and risk for development of coronary heart disease. In the past, people with arthritis were cautioned to rest and were specifically discouraged from participating in exercise activities. However, this approach has begun to change over the last quarter of a century. Since 1975, study results have consistently indicated that moderate-intensity aerobic exercise is both safe and physically and psychologically beneficial for people with arthritis.
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Although persons with arthritis tend to be less fit than their peers without arthritis, studies have demonstrated that many persons with arthritis can safely participate in appropriate conditioning exercise programs to improve cardiovascular fitness, muscle strength, psychosocial status, and functional status. The Surgeon General’s Report on Physical Activity and Health concluded that regular moderate aerobic or resistance-training exercise programs relieve symptoms and improve function in people with rheumatoid arthritis and/or osteoarthritis.
The Thurston Arthritis Research Center at the University of North Carolina at Chapel Hill is currently conducting two studies of physical activity interventions in 31 different urban and rural communities across the state of North Carolina. One study is examining the effect of People with Arthritis Can Exercise (PACE), a community-based group recreational exercise program developed by the Arthritis Foundation. The other study is examining the effects of Active Living Every Day (ALED), a behavior-based program that addresses the root cause of physical activity, developed jointly by the Cooper Institute, Brown University, and Human Kinetics.
PACE is a traditional structured exercise approach and ALED is a lifestyle intervention with an emphasis on behavioral skill building and integration of a wide variety of moderate intensity activities accumulated over the course of the day. Not all individuals respond to the same types of interventions and it is hoped these studies will help show what benefits different approaches can have for people with arthritis.
No matter what these studies conclude, it is safe to say now that individuals with arthritis should be encouraged to engage in moderate levels of physical activity for at least 30 minutes, and preferably longer, on most days of the week. Exercising every day will provide even more benefits. A wide variety of activities can be appropriate for this purpose, including walking, swimming, bicycling, dancing and gardening, to name just a few.The key to success in exercise is to find an activity that you enjoy, because then you are more likely to keep at it consistently.
Leigh Callahan, PhD, is an associate professor in the Department of Orthopaedics at the University of North Carolina at Chapel Hill School of Medicine.