Rheumatoid arthritis Flashcards
What is RA
RA is an autoimmune disease
Affects 1% of the general population
Aetiology not known – genetics? Environment?
No cure
(lee & weinblatt 2001)
Symptoms of RA
- Pain, stiffness and swelling in joints
o Structural damage if not treated adequately - Heart, lung and blood vessels are also influenced
- High grade systemic inflammation
- RA is characterised by flares
(Lee & Weinblatt 2001) - High levels of fatigue (Treharne et al 2008)
- High levels of depression ( Treharne et al 2008)
- Welbeing is affected (Gettings 2010)
Potential causes –
- Hypertension
- Obesity
- Endothelial Dysfunction, Hypercholesterolaemia
- Insulin Resistance
- Physical Inactivity
(Kitas & Gabrial, 2011)
Medication
Focussed on reducing inflammation and relieving pain/discomfort
* Steroids * NSAIDs * DMARDS * Biologics * anti-TNF / anti-IL-6
Patients often on a mix of medications
Assessments of Disease Activity
DAS28
* Inflammation:
* CRP, ESR
* Joint ‘health’:
* radiographic damage
Summary RA & exercise
Summary RA & exercise
* Combined aerobic and resistance most commonly used
- Appropriate exercise programmes
- Increase cardiorespiratory fitness
- Improve function ability
- Do not aggravate RA
- Reduce the risk for CVD
Physical Activity Guidelines for RA
1.an integral part of standard clinical care of people with RMDs (RauschOsthoff et al 2018; Gwinnutt et al 2022)
2.offered as an adjunct treatment in newly diagnosed patients (Combe et al 2017)
3.offered in the management of specific symptoms (e.g., pain) and comorbidities (e.g., cardiovascular disease,) (Geenen et al 2018; Agca et al 2017)
4.a key self-management strategy in RMDs (Nikiphorou et al 2021)
How can we encourage people with RA to be more active
- Similar barriers, but different ways of coping with the barriers (e.g., Wilcox et al 2006)
- Only when impact is taken into account, associations between barriers and PA behaviour (e.g., Gyurcsik et al 2009)
- Role for self-efficacy for exercise and barrier self-efficacy
Veldhuijzen van Zanten et al 2015
