Rheumatoid Arthritis Flashcards
what is RA?
an auto immune disease affecting joints
how much of the population is affected by RA?
1 %
mostly affecting women
what are symptoms of RA?
- pain/stiffness/swelling of joints
- high grade systemic inflammation
- high fatigue
- high depression
how many people with RA meet exercise guidelines x3 a week ?
who said it ?
13.8 %
sokka et al 2008
what did kitas & Gabriel (2011) say about what might cause RA?
hypertension
obesity
insulin resistance
physical inactivity
what can be used to assess RA?
DAS 28
assesses 28 joints
squeeze joint to assess swelling/inflammation/pain
what are inflammation blood markers for RA?
CRP (C-reactive protein)
ESR (erythrocyte sedimentation rate)
what medications might be used and why ?
steriods
NSAIDs
DMARDS
biologics
help reduce inflammation + relieve pain/discomfort
what did Bausch Osthoff et al 2018 say about exercise ?
exercise should be an integral part of clinical care for those with RA
what did genes et al 2018 say about exercise ?
exercise should be offered in management,ent of symptoms such as pain and co-morbidities like CVD
what did stavropoulos-kalinglou et al 2013 research do ?
6 month intervention
1-3 aerobic x 3 a week at 70% VO2
3-6 aerobic+ resistance x3 a week at 70%VO2 + 70% 1RM
who found the results to that study ?
Stavropoulos- Kalinglou et al (2013)
improved cardiorespiratory fitness (VO2 max)
DAS 28 scores improved - reduced inflammation
HAQ scores improved (scored lower so increased function in daily life)
what did veldhuijzen van zanten et al 2019 do in their study exercise vs medicine + what did they find ?
women only
exercised x3 week: 2 at centre, 1 at home @ 70% max HR
pps start on anti-tnf treatment
- this group has higher disease activity at baseline
BOTH groups had improvement in DAS28 & HAQ
greater improvement in anti-tnf group
CRP decreased in both groups
Anti-tnf treatment reduces CVD activity but exercise improves function of vasculature
what might be a limitation of the study above ?
women only - can’t generalise
small sample size
not everyone will have access to facility to exercise in
what did Veldhuijzen van Zanten et al (2015) see as barrier/ facilitators and benefits of exercise ?
barrier -
pain
fatigue
mobility issues/stiff
facilitator -
- strength/aerobic capacity
- exercise instructions
- support
benefit-
- symptom management
- pain relief
- independence
