Arthritis powerpoint involving RA and OA and the effects exercise has on these disabilities

1. Nathan Myers Arthritis

2. 46 million Americans suffer from at least one of the 100+ types of arthritis Most common RA- Rheumatoid Arthritis Osteoarthritis Oldest and most prevalent form of arthritis 27 million Americans suffer from OA AKA Degenerative joint disease (DJD) Accounts for 25% of visits to primary physicians and half of the non steroidal anti-inflammatory drug prescriptions Overview

3. Results from loss of cartilage in synovial joints, mainly weight bearing. Bone spurs and cysts result from the loss of cartilage Primary OA Mainly characterized by wear and tear of aging Secondary OA Can be induced by injury, genetics, or obesity at an earlier stage of life Osteoarthritis (OA)

4. Cause is not completely understood Chronic and debilitating Characterized by inflammation of synovial membrane Leads to deterioration of bone and cartilage Different from OA RA is associated with abnormal level of the antibody rheumatoid factor (RF) Therefore, known as an autoimmune disease Rheumatoid Arthritis

5. Arthritis leads the way in disabling people over age 55 No cure Only preventions and management options are available Depending on the person, Arthritis may affect people at earlier ages in life Relevance

6. If the subject has systemic rheumatic disease, then severity of flare-ups must be considered before they can exercise. Major concern with this population is Vasculitis Vasculitis– swelling of the blood vessels Can hinder blood flow to organs Can lead to organ failure or even death Flare-ups of systemic illness can prevent this population from being capable of exercise. Encouraged to move affected joint through full ROM during times of flare-ups and cease exercise for rest. Effects of Exercise

7. Tend to be less fit and less active Resting energy expenditure is higher even if the systemic disease is controlled by a physician Biomechanical inefficiency due to pain and stiffness of the joint Rapid repetitive movements are hindered– narrows mode of exercise Mode of exercise is dependent on site and severity of affected joint Results of having Arthritis pertaining to exercise capacity

8. Improved Aerobic capacity, endurance, strength, and flexibility are improved with the following: improved function Decreased swelling of the joint Decreased pain Increased social and physical activity in daily activities Reduced depression and anxiety Low to moderate, progressed exercise favors this population the most. Benefits from Exercise Training

9. Analgesics– acetaminophen Nonsteroidal anti-inflammatory drugs Salicylates– aspirin NSAIDS- ibuprofen/naproxen Corticosteroids- prednisone Disease modifying antirheumatic drugs (DMARDs) Azathioprine/Cyclospirone Biologic response modifiers- Tumor Necrosis factor (TNF) blcokers Medications

10. DMARDs and BRMs function to target specific immune processes that are believed to cause the inflammation and tissue damage Rest of the medications mainly target symptoms of stiffness, pain and inflammation. If symptoms cannot be controlled with one medication, then a combination of slow acting DMARDs is usually the favorable drug therapy. Medications

11. The focus of the program should be joint protection. Low impact exercises Functional exercises for strength when possible Any activities that require prolonged one legged stances or stop and go actions should be avoided for hip and knee arthritis Also, contact sports and exercises involving stairs should be avoided. Overstretching should be avoided If pain or swelling persists, exercise should be stopped or modified to a non-weight bearing position. Recommendations for Exercise

12. Key components Flexibility and ROM of joints should be the focus Set time goals not distance goals Exercise can be modified to several bouts during the day instead of one bout a day Rigid arch supports may need to be used if weight bearing exercises causes pain Recommendations for Exercise

13. Exercise Prescription

14. http://www.youtube.com/watch?v=VKq0S-uA_Rs Knee Scope with Arthritis

15. Durstine, J. Larry., Moore, Geoffrey E. ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities. (2003). 2.149-153. American College of Sports Medicine (Janet P. Wallace). References