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Too Many Rheumatoid Arthritis Patients Inactive, Study Finds
Date:1/26/2012

By Steven Reinberg
HealthDay Reporter

THURSDAY, Jan. 26 (HealthDay News) -- More than 40 percent of rheumatoid arthritis patients live a sedentary life, a new study finds.

It used to be thought that medication and rest was the best treatment, but now experts believe physical activity is important to keep joints flexible, improve balance and strength and reduce pain, the researchers noted.

"Our results suggest that public health initiatives need to address the lack of motivation to exercise and to promote the benefits of physical activity to reduce the prevalence of inactivity in those with rheumatoid arthritis," said lead researcher Jungwha Lee, an assistant professor in the department of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago.

Physical inactivity among these patients is a public health concern, Lee said.

"Enhancing strong motivation for physical activity and strong beliefs in the benefits of physical activity may help rheumatoid arthritis patients to be more physically active," she said.

The report was published in the Jan. 26 online edition of Arthritis Care & Research.

For the study, Lee's team collected data on 176 patients with rheumatoid arthritis aged 18 and older who took part in a trial assessing the effectiveness of physical activity.

In addition, they looked at the relationship between inactivity and risk factors such as obesity and pain, and also the motivation for physical activity.

They found that 42 percent of the patients were inactive. These people didn't participate in the moderate-to-vigorous physical activity program in the trial, which consisted of periods of activity at least 10 minutes during the week.

Moderate physical activity is equivalent to brisk walking, Lee said.

Moreover, 53 percent of the patients weren't motivated to do physical activity and 49 percent didn't think exercise would benefit them, Lee's group found.

These reasons accounted for 65 percent of the inactivity, they noted.

Dr. Jon Giles, an assistant professor of medicine in the division of rheumatology at Columbia University's College of Physicians and Surgeons in New York City, said that "the most striking aspect to me about the paper is that although we generally consider joint pain and damage as the reason that rheumatoid arthritis patients may not exercise, this does not appear to be the primary driver of lack of exercise in the group studied.

"Low activity motivation and lack of belief in the benefits of exercise are actually the primary reasons for physical inactivity in the general population, so it is interesting that rheumatoid arthritis patients are actually not very different from their non-rheumatoid arthritis counterparts," he added.

Another expert, Dr. Waseem Mir, a rheumatologist at Lenox Hill Hospital in New York City, said that part of the problem is that many patients don't really have their arthritis under control.

"Their physical activity is lacking because they have stiffness, pain and fatigue, so there are a lot of factors involved," he said.

Many of these patients just don't feel well, he said. "They feel really beat up," he said. "These patients feel wiped out day in and day out."

Mir noted that exercise for these patients is important not only to maintain flexibility and strength, but because they are already at an increased risk for heart disease. "Their inactivity only adds to that risk," he said.

In the United States, almost 1.3 million people suffer from rheumatoid arthritis, according to the American College of Rheumatology.

The condition is characterized by inflammation of the joints, which leads to stiffness, pain and loss of function.

More information

For more on rheumatoid arthritis, visit the Arthritis Foundation .

SOURCES: Jungwha Lee, Ph.D., M.P.H., assistant professor, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago; Jon T. Giles, M.D., M.P.H., assistant professor, medicine, division of rheumatology, Columbia University, College of Physicians and Surgeons, New York City; Waseem Mir, M.D., rheumatologist, Lenox Hill Hospital, New York City; Jan. 26, 2012, Arthritis Care & Research, online


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