COLUMNS: Special Populations
Osteoarthritis (OA) and rheumatoid arthritis (RA) are 2 common arthritic conditions (4–6). The U.S. Centers for Disease Control and Prevention project that the number of cases of OA and RA will increase to 60 million by 2020 (5). OA is a degenerative joint disease and RA is an autoimmune, inflammatory, systemic disease (4,5). Both diseases cause pain, stiffness, swelling of articular structures, muscle weakness, and atrophy. People with OA and RA also may experience physical activity intolerance, deconditioning, and an increased risk of other chronic diseases (1,4–6). Table 1 lists more common signs and symptoms associated with OA and RA. The next section will discuss some of the observed benefits of resistance training for persons with OA and RA.
BENEFITS OF RESISTANCE TRAINING IN PATIENTS WITH OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS
Resistance training (RT) has been shown to improve muscle strength, functional capacity, and pain tolerance in both OA and RA patients (1,2–6). It also increases muscle cross-sectional area (3) while not increasing disease activity (1,6).
RESISTANCE TRAINING PROGRAMMING FOR OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS
The development of an RT program should be based on individual needs (1,2,4–6). People with arthritis should discuss safe, effective exercise options with a physician or other health care provider before engaging in an RT program. Starting beginners with 2 to 3 repetitions might help initiate muscle adaptations while lowering the risks of increased joint pain and swelling (2,4). Patients should progress to 10 to 12 repetitions per exercise, as tolerated (4). Isometric exercises may be required initially if there is significant joint pain (4–6). One set per exercise will be sufficient for beginners. However, multiple-set programs will generally be well tolerated and more effective in the long term (4). Progression should occur according to the person's response to training. A variety of RT equipment can be used. Table 2 summarizes resistance training recommendations for persons with arthritis.
SIGNS AND SYMPTOMS OF OVEREXERTION
Exercise specialists should familiarize themselves with signs and symptoms of overexertion and exercise intolerance. They can include persistent fatigue, increased weakness, decreased range of motion, increased swelling, and continuous pain lasting more than 1 hour after exercising (5). If any of these signs or symptoms occurs, exercise training should be discontinued and the person should contact his or her physician. Table 3 lists resistance training indications and special considerations for individuals with OA and RA.
Individuals with OA and RA may lead a greater quality of life as a result of participating in regular RT. Exercise professionals should acquire the necessary knowledge of OA and RA when designing RT programs for this population to ensure adequate safety and effectiveness.
Millar AL. American College of Sports Medicine: action plan for arthritis. Human Kinetics, 2003.
The Arthritis Foundation (http://www.arthritis.org). The Arthritis Foundation provides information to professionals and patients regarding research and new developments in the diagnosis and care of arthritis.□
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