Rhematoid Arthritis Flashcards
What is Rheumatoid Arthritis (RA)?
Autoimmune disease
Affects 1% of general population
What is the aetiology of Rheumatoid Arthritis (RA)?
Aetiology not known
Possible factors include genetics and environment
Is there a cure for Rheumatoid Arthritis (RA)?
No cure
What are the symptoms of RA?
Symptoms of RA
What are the symptoms of Rheumatoid Arthritis (RA)?
Pain, stiffness and swelling in joints
Structural damage if not treated adequately
What other areas of the body are influenced by RA?
Heart, lung and blood vessels are also influenced
High grade systemic inflammation
How is RA characterized?
RA is characterised by ‘flares’
Lee & Weinblatt 2001
What is the increased prevalence of cardiovascular disease associated with?
Rheumatoid Arthritis
(Kitas & Gabriel, 2011)
What are potential causes of cardiovascular disease and rheumatoid arthritis?
- Physical Inactivity
- Hypertension
- Obesity
- Endothelial Dysfunction
- Hypercholesterolaemia
- Insulin Resistance
(Kitas & Gabriel, 2011)
What is the sample size of the exercise group?
N = 20
What type of exercise program was used in the exercise group?
Individualised exercise (Action Heart)
What assessments were conducted in the exercise group?
Assessments @ baseline, 3 months, & 6 months: Fitness, Endothelial Function, Fasted Blood Sample
What is the sample size of the control group?
N = 18
What intervention was provided to the control group?
Exercise advice
What is the frequency of the exercise programme for Month 1-3?
3 times per week
What is the intensity of aerobic training for Month 1-3?
70% of VO2max
What type of exercises are included in Month 1-3?
3 circuits of 3-4 aerobic exercises in intervals of 3-4 mins
What is the total time for the exercise programme in Month 1-3?
60 mins
What is the frequency of the exercise programme for Month 3-6?
3 times per week
What is the intensity for aerobic training in Month 3-6?
70% of VOmax
What is the intensity for resistance training in Month 3-6?
70% of 1RM
What type of aerobic exercises are included in Month 3-6?
3 circuits of 3-4 aerobic exercises in intervals of 3-4 mins
What type of resistance exercises are included in Month 3-6?
1 set of 12-15 reps of leg press, shoulder press, chest press, pull ups
What is the total time for the exercise programme in Month 3-6?
70 mins
What is the baseline duration in the study?
3 months
What are the significant interaction effects observed?
All significant Group & Time interaction effects
What are the durations mentioned in the study?
Baseline, 3 months, 6 months
Which study discusses RA & exercise?
Stavropoulos- Kalinogiou et al (2013), Ann Rheum Dis, 72: 1819-25
Which other study is referenced regarding RA & exercise?
Motsios et al (2014), Ann Rheum Dis, 73: 748-51
What type of exercise is most commonly used for RA?
Combined aerobic and resistance
What are the benefits of appropriate exercise programmes for RA?
Increase cardiorespiratory fitness, Improve function ability, Do not aggravate RA, Reduce the risk for CVD
What should physical activity (PA) be in the care of people with RMDs?
PA should be an integral part of standard clinical care of people with RMDs.
(Rausch Osthoff et al 2018; Gwinnutt et al 2022)
How should PA be offered to newly diagnosed patients?
PA should be offered as an adjunct treatment in newly diagnosed patients.
(Combe et al 2017)
In what context should PA be offered for symptom management?
PA should be offered in the management of specific symptoms (e.g., pain) and co-morbidities (e.g., cardiovascular disease).
(Geenen et al 2018; Agca et al 2017)
What role does PA play in self-management strategies for RMDs?
PA is a key self-management strategy in RMDs.
(Nikiphorou et al 2021)
What was the sample size and demographic of the exercise intervention group?
20 patients with RA, average age 55 (10) years, 10 women.
How was the exercise intervention individualized?
Based on patient’s preference and ability.
How often did patients participate in the exercise intervention?
3 times/week (twice in exercise centre and once at home).
What was the intensity of the exercise intervention?
70% of maximal Heart Rate.
What was the sample size and demographic of the anti-TNF treatment group?
23 patients, average age 54 (15) years, 15 women.
What was the treatment focus for the anti-TNF group?
Starting anti-TNF treatment.
Who conducted the study referenced?
Veldhulzen van Zanten et al 2019.
What are the beneficial effects of exercise and anti-TNF treatment in RA?
Both exercise and anti-TNF treatment have beneficial effects in RA.
How does successful anti-TNF treatment affect cardiovascular risk?
Successful anti-TNF treatment improves cardiovascular risk by reducing disease activity.
How does exercise improve cardiovascular risk?
Exercise improves cardiovascular risk by enhancing the function of the vasculature.
What may reduce the risk for CVD after successful anti-TNF treatment?
Increasing levels of physical activity may reduce the risk for CVD after successful anti-TNF treatment.
Who conducted the study referenced in the conclusion?
Veldhuizen van Zanten et al 2019.
What is the relationship between successful medication and physical activity (PA)?
Following successful medication, there is an increase in PA and a decrease in sedentary time.
When might be the best time to implement an exercise program for patients?
Perhaps the best time to implement an exercise program is when patients are already increasing PA.
How active are patients with rheumatoid arthritis (RA)?
Patients with RA are less active than others.
What is the activity level of patients with RA compared to the general population?
Patients with RA are less active than the general population.
Sokka et al 2008, Tierney et al 2012
What was the sample size of the study on RA patients’ activity levels?
N = 5,235
How many countries were involved in the RA activity study?
21 countries
What percentage of RA patients reported no regular activity?
70%
What percentage of RA patients exercised 3 times a week?
13.8%
What type of study was conducted on RA patients’ activity levels?
Cross Sectional
What is the focus of Veldhuijzen van Zanten et al 2015?
Barriers for active vs inactive people with RA
RA refers to rheumatoid arthritis.
What do Wilcox et al 2006 suggest about barriers?
Similar barriers exist, but there are different ways of coping with them.
What is necessary to understand the association between barriers and PA behavior?
The impact must be taken into account.
PA refers to physical activity.
What role does self-efficacy play according to Veldhuijzen van Zanten et al 2015?
Self-efficacy for exercise and barrier self-efficacy are important.
What does ‘Strenge and aerobie capacity’ refer to?
It is not defined in the provided text.
What is the significance of Gyurcsik et al 2009?
They highlight the importance of considering impact when examining barriers and PA behavior.
What is known about the long-term effect of an exercise intervention?
Little is known about the long-term effect of an exercise intervention.
What theory can support behavior change in exercise interventions?
Self-determination theory (SDT) can support behavior change.
What was the conclusion regarding the intervention’s effect on motivation?
The intervention was successful at increasing autonomous motivation.
What was the outcome regarding cardiorespiratory fitness?
There were no changes in cardiorespiratory fitness.
What is suggested for translating motivation into action?
More intense support is needed with the exercise programme.
What is the implication of increased motivation?
Motivation increased, but more help is needed to exercise at the right intensity to achieve health benefits.
