Does Exercise Help Your Arthritis?
Joint range-of-motion exercises for flexibility, strengthening exercises, and aerobic conditioning exercises have been shown in most studies to be safe and effective in improving physical fitness for patients with osteoarthritis or rheumatoid arthritis. Less clear are the therapeutic benefits of exercise, with most studies reporting that arthritis is not improved or worsened because of exercise training.
There are many potential benefits of exercise for the individual with arthritis:
- Improvement in joint function and range of motion
- Increase in muscular strength and aerobic fitness to enhance daily activities of living
- Elevation of psychological mood state
- Decrease in loss of bone mass
- Decrease in risk of heart disease, diabetes, hypertension, and other chronic diseases
Can regular exercise improve, stop the progression, or even cure arthritis? Most researchers who have studied this question now answer no. While exercise for people with arthritis is important for all the reasons just listed, investigators have typically found that exercise training does not improve arthritis but that it does not worsen the disease process either. In other words, exercise does not affect the underlying disease state in people with arthritis one way or the other, but does improve many other areas of importance to life quality.
Dr. Pamela Kovar of Columbia University, for example, randomly divided 102 patients with osteoarthritis of the knee into walking and control groups. Those in the walking group walked up to 30 minutes, three times a week, for eight weeks. As shown in figure 8.3, the walkers experienced a strong increase in their performance during a six-minute walking test, an effect, says Dr. Kovar, “that was achieved without exacerbating pain or triggering flares.” In other words, those with osteoarthritis became fitter with the exercise program, but their disease was not reversed.
Dr. Eric Coleman of the University of Washington in Seattle divided elderly subjects with a history of mild to moderate arthritis into four groups: strength training (two sets and 10 repetitions of eight different weight machine exercises, three days a week), stationary cycle training (35 minutes at 60 to 75 percent intensity, three days a week), both strength and cycle training, and controls. After six months of training, strength improved significantly in all exercise groups, but especially in those who worked out on the weight machines. Joint pain symptoms did not improve or worsen in any group. “In this study, we found no evidence that well regulated exercise produces or exacerbates joint pain in healthy community-dwelling older adults with mild to moderate joint symptoms,” concluded Dr. Coleman.
Other researchers have come to the same conclusion: patients with arthritis are trainable (i.e., they can get stronger and more aerobically fit), and the exercise can be done safely without detrimental effects on the joints. However, as emphasized by Dr. Troels Hansen of Herlev University Hospital in Denmark, who measured the influence of exercise training in 75 patients with rheumatoid arthritis over a two-year period, “The results showed no effect of training on the disease activity or on the progression of the disease.”