RA EaM

Question 1

prevalence of RA

Answer 1

starts between 40-60
Over 400,000 in UK
More common in Women
(Versus Arthritis)

Question 2

symptoms of RA (7)

Answer 2

joint pain
inflammation
stiffness after being sttaionary (eg. Night or sitting)
flares
fatigue
depression
They are at increased risk of CVD due to hypertension, obesity, inactivity
(kitas et al., 2011)

Question 3

standard management of RA (3)

Answer 3

Reducing disease activity and mx of flares
(lee et al., 2011)
Fatigue management due to high levels of fatigue
(Treharne et al 2008)
drugs to reduce inflammation (corticosteroids, DMARDs, NSAIDSs, painkillers)

Question 4

why do those with RA need PA intervention

Answer 4

Less active than gen pop with 70% not taking part in reg PA
(Sokka et al., 2008)
Have 20-30% lower aerobic capacities than age matched healthy controls
(Cooney et al., 2011)

Question 5

benefits of exercise for those with RA (3)

Answer 5

reduce pain, stifness and fatigue.
Improve functional ability and psychological well-being.
Does not exacerbate disease activity
(Cooney et al., 2011)

Question 6

benefits of Aerobic training (5)

Answer 6

improve aerobic fittness, strength, joint mobility, psychological well-being and reduces CVD risk
(Cooney et al., 2011)

Question 7

benefits of Resistance training

Answer 7

increase muscle strength, reduce inflammation, pain, morning stiffness and disease activity
(Cooney et al., 2011)

Question 8

Gaps in the research

Answer 8

Patient barriers need to be further considered to develop realistic and appropriate programmes to facilitate real world application
(Canning et al., 2023)

Question 9

outcome measures used for RA (10)

Answer 9

disease activity (DAS28)
pain (VAS, NRS)
joint ROM
muscle strength (grip)
functional ability (HAQ)
QOL
depression + anxiety (HADS, BDI)
function (TUG, 6MWT, STS),
inflammatory markers (CRP, ESR, IL-6, TNF-a)
CVD risk factors (BP, endothelial function/elasticity)

Question 10

As depression is common in RA, what is the evidence to back up the use of exercise

Answer 10

Exercise improves anxiety, depression, mood, fatigue (Mikkelson et al., 2017)

Question 11

inflammation plays a key role in RA and the other health conditions discussed. Why are its markers relevant to psychological well-being

Answer 11

decreased levels of inflammatory markers, such as CRP, IL-6, and TNF-α should correlate well with reduced anxiety, depression, stress and fatigue