Rheumatoid Arthritis

Question 1

Describe the definition and pathophysiology of RA

Answer 1

Definition: a systemic inflammatory disorder; an autoimmune disease. Pathophysiology: characterized by systemic inflammation which predominantly affects synovial linings causing Synovitis. Joint destruction 1-2 years after onset

Question 2

List four main signs and symptoms for RA

Answer 2

1. Slow onset accompanied w/ fatigue,loss of appetite or fever. 2.Stiff joints in the morning - but does not worsen throughout the day. 3. Subcutaneous rheumatoid nodules. 4. Pain in the hands, feet, cervical spine.

Question 3

Describe the responses/benefits of ex for people w/RA

Answer 3

Increased: flexibility, strength, fitness, QOL, ADL. Decreased: pain, burden from co-morbidities, risk factors, inflammation and stiffness

Question 4

Describe the contraindications to ex for people w/RA

Answer 4

Avoid strenuous ex during flare ups and inflammation; avoid high impact or excessive joint stress exs; pain after ex >2 hrs than before may need to be reduced in future; normal to have small amount of pain after ex

Question 5

What are the key conclusions of Neuberger’s effects of ex regarding RA?

Answer 5

Positive effects found in hand grip strength and walk time; fatigue, perceived benefits/barriers to ex influenced ex participation; overall symptoms: depression, fatigue, pain were influenced in ages 40-70 yrs

Question 6

What are the recommendations and modifications for people w/RA

Answer 6

Aerobic: F = 3-5 d/wk; I = 40-60% HRR; T = > 150 m/wk or in 10 min bouts; T = modalities assoc. w/ low joint stress.

Resistance: F = 2-3 d/wk; I = 10-15 reps @ 40-60% 1RM; T = > 1 set of 8-10 exercises; T = including all major muscle groups

Flexibility and ROM exercises should also be added into programme to perform daily; morning and night

Question 7

Demographics for RA

Answer 7

1% of the population affected (40,000)

Any age, mainly 40-50, women:men 3:1