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Exercise as medicine exam > Rheumatoid Arthritis > Flashcards

Rheumatoid Arthritis Flashcards

1
Q

What is RA?

A

An autoimmune disease

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2
Q

Is are more prevalent in men or women?

A

women

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3
Q

What % of the population does RA effect?

A

1%

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4
Q

Why is there no cure?

A

As the aetiology (cause) is not known

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5
Q

What are the symptoms of RA?

A

-Pain, stiffness and swelling in joints
-Heart, lung and blood vessels inflamed
-RA is characterised by ‘flares’

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6
Q

As well as the joints, what are additional symptoms of RA?

A

-High levels of fatigue
-high levels of depression
-wellbeing is effected

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7
Q

What is a common cause of mortality in RA patients?

A

Cardiovascular disease as there is an increased prevalence

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8
Q

What are the potential causes of RA?

A

-Hypertension
-Obesity
-Insulin resistance
-Endothelial dysfunction
-Hypercholesterolaemia
-Physical inactivity

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9
Q

How do you assess RA?

A

-DAS28
-Inflammation
-‘Joint’ health radiographic image

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10
Q

What is medication for RA focused on?

A

-decrease inflammation
-reliving pain and discomfort

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11
Q

What are the types of medication for RA?

A

-Steroids
-NSADIs
-DMARDs
-Biologies (Anti-TNF/anti- IL-6)
(patients are often on a mix of medications)

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12
Q

What is improved with exercise in RA?

A

-disease activity
-functional ability
-improved CV risk factor with exercise

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13
Q

How is the risk of CV reduced in RA with exercise?

A

-decrease blood pressure
-improvement in endothelial function with exercise

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14
Q

What is the most common form of exercise used for individuals with RA?

A

Aerobic and resistance

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15
Q

What do appropriate exercise programmes include?

A

-increase to cardiorespiratory fitness
-does not aggravate RA
-increase functional ability
-decrease risk of CVD
-support for fatigue

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16
Q

What are the physical guidelines for an individual with RA?

A

70%VO2max
3x per week

17
Q

How does medication and exercise effect the CVD risk?

A

medication- reduces CVD risk by decreasing disease activity
exercise- improves CVD risk by increased function of the vascular

18
Q

When should PA be increased?

A

When an individual responds to medication (anti-TNF)

19
Q

What % of RA patients are not regularly active?

A

70%

20
Q

What % of RA patients exercise 3x per week?

A

13.8%

21
Q

What are some barriers for exercising in RA patients?

A

-Pain
-Fatigue
-Stiffness
-Mobility
-Lack of RA exercise programmes

22
Q

What are the benefits of exercising in RA patients?

A

-Symptom management
-Pain relief and distraction
-Joint function
-Independence

23
Q

What are the facilitators of exercising in RA patients?

A

-Support
-Exercise Instructors
-Health care providers
-Family/Friends
-Strength and aerobic capacity

24
Q

What benefit does improved self-efficacy have in people with RA?

A

more chance of overcoming the barriers for exercise

25
Q

Within the intervention, what will increase autonomy of the individual?

A

-promotes choice and understanding
-provides rationale
-input into the decision making
-promoting motivation

26
Q

How is autonomous motivation improved?

A

Via exercise

27
Q

What help is needed during the exercise programme?

A

-right intensity to achieve health benefits
-help changing motivation into action
-intense support

28
Q

What are the European PA guidelines for RA?

A

-Clear personalised aims, evaluated over time
-Type, intensity, frequency, duration, mode should all be personalised

29
Q

What should a PA intervention for RA patients include according to the European PA guidelines for RA?

A

-self-monitoring techniques
-goal setting
-action planning
-feedback
-problem solving

30
Q

What should PA recommendations aim to improve according to the European PA guidelines for RA?

A

-Cardiorespiratory fitness
-Muscle strength
-Flexibility
-Neuromotor performance

31
Q

What does RA contribute too? why?

A

-fatigue
-inflammation and pain and side effect of medication

32
Q

RA effects mental health. What does this impact?

A

-behavioural responses
-cognitive appraisal
-mood
–>this can all impact on fatigue

33
Q

What is a way of treating fatigue?

A

-medication (DMARDs)
-adjusting medications
-PA (reference- Pope et al, 2020)

34
Q

How long should an exercise intervention be to prove effective in helping improve fatigue?

A

<12weeks rather than 24weeks
(reference- Ronger-Van Dartel et al, 2014)

35
Q

What are the European fatigue management recommendations?

A

-health professionals should regularly assess fatigue severity, impact and coping strategies into clinical consultations
-as part of their clinical care, RA and fatigue suffers should be offered tailored PA interventions and encouraged into longer term PA
(reference- Dures et al, 2023)

Exercise as medicine exam (15 decks)

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