exercise prescription in rheumatology

Question 1

what is physical activity?

Answer 1

any movement that its carried out by the muscles that requires energy

Question 2

what is exercise?

Answer 2

-subcategory of physical activity that is planned, repetitive, purposefully focused on improving or maintaining one or more components of physical fitness

Question 3

what is therapeutic exercise?

Answer 3

any form of supervised or unsupervised exercise or physical activity specifically provided to patients to treat a condition
-can include any type of exercise eg strengthening, stretching

Question 4

what are examples of immediate health benefits of physical activity for adults?

Answer 4

-improves sleep quality
-less anxiety
-reduces BP

Question 5

what are examples of long term health benefits of physical activity for adults?

Answer 5

-reduces risk of developing dementia and depression
-lowers risk of heart disease and T2D
-prevents cancer
-reduces risk of weight gain
-improves bone strength
-improves balance and co-ordination & reduces risk of falls

Question 6

what anti-inflammatory effects does exercise have?

Answer 6

-reduction in visceral fat mass
-increased production & release of anti-inflammatory cytokines from skeletal muscle
-release of cortisol and adrenaline

Question 7

what is exercise-induced hypoalgesia?

Answer 7

it is when exercise can cause a reduction in pain sensitivity

Question 8

in terms or RA, what are the barriers to engaging with PA and exercise?

Answer 8

-symptoms eg pain and fatigue
-worry about causing harm
-lack of knowledge about exercise
-boring, not fun
-co-morbid conditions
-envionmental conditions eg weather , transportation and cost

Question 9

in terms of OA, what are examples of barriers to engaging with PA and exercise?

Answer 9

-lack of knowledge and unclear about exercise
-lack of motivation
-fear of pain
-beliefs about OA
-co-morbid conditions
-lack of social support

Question 10

what is the PAR-Q+ questionnaire?

Answer 10

-it is the physical activity readiness questionnaire
-it determines if its safe for someone to exercise
-it identifies any health risks that might be worse after exercise

Question 11

what are the main types of exercise?

Answer 11

-aerobic exercise such as walking, cycling, swimming
-neuromuscular control/ muscle strengthening - elastic bands, body weight and weights
-balance and flexibility - yoga and tai chi

Question 12

what are important considerations in inflammatory arthritis / RA?

Answer 12

-RA is associated with a bigger risk of CVS events and or diseases such as athertoscelorosis or congestive cardiac failure
-adequeate disease control is necessary to reduce the risk
-physical activity is important to reduce cardiovascular disease risk

Question 13

is there a higher prevalence of osteoporosis in RA patients?

Answer 13

there is a higher prevalence of oesteoporosis in RA than the general population

Question 14

what are practical recommendations for exercise prescription in RA?

Answer 14

-active joint ROM - 1-2 times a day, 6-10 reps per affected joint + push only to range that is comfortable
-physical activity - swimming and cycling recommended , avoid high impact activities
-strength training- dynamic exercises, low to moderate load with high repetitions

Question 15

in terms of strength training, what is recommended during a flare up?

Answer 15

during a flare up, revert back to isometric exercises

Question 16

what e=behaviour change techniques promote physical activity in OA according to a systematic review of 24 RCTS?

Answer 16

-non specific award
-patient led goal setting
-self monitoring of behaviour
-social support

Question 17

what are some practical guidelines for implenting exercise for hip OA and knee OA?

Answer 17

-therapuetic exercise is SAFE
-strengthening exercise - 2-4 sets,8-12 reps and at least 2-3 times per week
-balance exercises to reduce falls risk
-aerobic exercise eg cycling, swimming