I've had a couple requests in the last week (mostly from my mother) to design an exercise program for rheumatoid arthritis (RA). I thought it would be a good idea for a blog post. This post will cover the benefits of resistance exercise for RA.
Exercise programs for RA have historically been more focused on aerobic type exercise because of the increased risk of cardiovascular events. There's absolutely nothing wrong with that and it has been shown that aerobic exercise improves quality of life, levels of pain/disability, and cardiovascular fitness in persons with RA. However, resistance exercise should not be ignored. In fact, studies show that resistance exercises can have an anti-inflammatory effect, reduce cardiovascular risk, and improve function.
|image soured from reachbeyondra|
Strength training using weights has been shown to be safe in a study by Strasser et al. (2011). Participants in the study performed bench press, chest cross (flys), bicep curls, triceps extensions, and sit ups. All participants had a disease duration of greater than 2 years and were also receiving drug therapy. In the study the participants lifting a weight that was 70% of the 1 rep max 10-15 times. Once they could perform more than 15 repetitions then the weight was increased. For the first two weeks they did one set of each exercise and from the third week onward they did two sets. By the end of the study disease activity and pain had decreased, while general health and function improved.
Basically what all this shows is that a combination of aerobic and resistance exercise is best for persons with RA - and for that matter people in general.
The problem is, as in my mother's case, it can be very difficult to hold onto weights when your haven't the grip strength in your hands, or range of motion in your fingers to properly grasp. So, what do you do? The answer is you do what your body lets you do. For people with advance RA exercises like the the ones mentioned above may not be appropriate, it's very important to speak to your doctor/rheumatologist to make sure exercises certain exercises are appropriate.
This will give you the ability to add some resistance to your upper body exercises. The use of machines in a gym may also be a good option because the risk of dropping the weight is eliminated. Like the study mentioned above, find a weight that you can do a maximum of 15 times and when you can lift that weight more than 15 times increase it.
Finally, water-based exercise is great for RA because the water adds resistance. Find programs at your local gym. I used to teach a class called joint action at my old gym in St. John's. If you're living in that area then give them a try here: http://www.newworldfitness.com/
I will not give an example exercise program in this post because exercises should be tailored for the individual. Speak to your doctor or a physiotherapist to get a program that suits your specific needs. For more information you can try the following links:
Baillet, A. et al. (2012). Efficacy of resistance exercises in rheumatoid arthritis: meta-analysis of randomized controlled trials. Rheumatology, 51, 519-527.
Strasser, B. et al. (2007). The effects of strength and endurance training in patients with rheumatoid arthritis. Clinical Rheumatology, 30(5), 623-632.