RHEUMATOID ARTHRITISMolly VanKerkhoff

WHAT IS RHEUMATOID ARTHRITIS? Most common type of autoimmune arthritis Chronic Inflammatory Disorder

Small joints in hands and feet Bone deformity and joint erosion Autoimmune disorder

Attacks the lining of the joints- Synovium Damage other organs

Eyes Skin Lungs Blood vessels

Normal Joint:

Joint with Rheumatoid Arthritis:

TYPICAL RA POPULATION Over 40 More common in women than men

Women between 25 and 50 1-3% of women in lifetime

1.5 Million Americans Women to men 3:1 75% of the population is women

LIVING WITH RHEUMATOID ARTHRITIS Early treatment When flare-ups occur

Gentle range of motion Stretching

Low impact, aerobic exercises Loss of appetite Fevers Dry eyes and mouth- Sjorgren’s Syndrome Loss of energy Limited joint mobility/function

Most often in the mornings

TREATMENTS Therapy

Lessen symptoms and improve function NSAIDs

Swelling, fever, pain DMARDs

Disease-Modifying Antirheumatic Drugs Low-dose corticosteroids Biologic-response modifiers or “biologic agents”

Those with more serious RA

TREATMENT CONTINUED Best treatment is not medicine alone Rheumatologist visits Continued X-Rays, blood tests, and ultrasounds Patient education

EXERCISING WITH RA EVERY patient with RA should exercise! MODERATE intensity, weight bearing activity Three main levels of exercise:

Therapeutic/Rehabilitative Recreational/Leisure Competitive/Elite

4 types Flexibility Strengthening Aerobic Body Awareness

Safe Aerobic Exercise: • Walking• Aerobic Dance• Aquatic Exercise• Biking• Elliptical• Treadmill

Moderate: • Walking• Biking• Swimming• Mowing grass• Doubles tennis• Dancing• Tai Chi, Yoga• Conditioning

machines• Sports

Vigorous: • Jogging/Running• Singles Tennis• Swimming • Jump Rope• Dancing• Conditioning Machines• Sports

EXERCISE TESTING Evaluate:

Disease activity Functional status Resources Expectations

Exercise testing is key! Baseline levels Tolerance Areas in need of improvement Exercise parameters

ACSM Rheumatoid Arthritis Exercise Test Table

EXERCISE PRESCRIPTION

REFERENCES http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/ba

sics/definition/con-20014868

http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/expert-answers/rheumatoid-arthritis/faq-20058245

http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/expert-answers/rheumatoid-arthritis/faq-20057897

http://www.niams.nih.gov/health_info/Rheumatic_Disease/default.asp http://my.clevelandclinic.org/orthopaedics-rheumatology/diseases-con

ditions/hic-rheumatoid-vasculitis.aspx

http://www.arthritis.org/conditions-treatments/disease-center/women/ http://www.rheumatology.org/practice/clinical/patients/diseases_and_c

onditions/ra.asp

http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Exercise_and_Arthritis/

http://www.cdc.gov/arthritis/pa_overview.htm http://www.ncpad.org/112/1236/Rheumatoid~Arthritis~and~Exercise