Rheumatoid Arthritis Flashcards by Izzy Boyden

What is RA?

An autoimmune disease

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Is are more prevalent in men or women?

women

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What % of the population does RA effect?

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Why is there no cure?

As the aetiology (cause) is not known

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What are the symptoms of RA?

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

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

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

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What is a common cause of mortality in RA patients?

Cardiovascular disease as there is an increased prevalence

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What are the potential causes of RA?

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

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How do you assess RA?

-DAS28
-Inflammation
-‘Joint’ health radiographic image

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What is medication for RA focused on?

-decrease inflammation
-reliving pain and discomfort

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What are the types of medication for RA?

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

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What is improved with exercise in RA?

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

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

-decrease blood pressure
-improvement in endothelial function with exercise

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

Aerobic and resistance

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What do appropriate exercise programmes include?

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

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What are the physical guidelines for an individual with RA?

70%VO2max
3x per week

How does medication and exercise effect the CVD risk?

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

When should PA be increased?

When an individual responds to medication (anti-TNF)

What % of RA patients are not regularly active?

70%

What % of RA patients exercise 3x per week?

13.8%

What are some barriers for exercising in RA patients?

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

What are the benefits of exercising in RA patients?

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

What are the facilitators of exercising in RA patients?

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

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

more chance of overcoming the barriers for exercise

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

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

How is autonomous motivation improved?

Via exercise

What help is needed during the exercise programme?

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

What are the European PA guidelines for RA?

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

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

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

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

-Cardiorespiratory fitness -Muscle strength -Flexibility -Neuromotor performance

What does RA contribute too? why?

-fatigue -inflammation and pain and side effect of medication

RA effects mental health. What does this impact?

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

What is a way of treating fatigue?

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

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

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

What are the European fatigue management recommendations?

-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)