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Session IV, Exercise in the Presence of Rheumatic Disease

  1. Top of page
  2. Session IV, Exercise in the Presence of Rheumatic Disease
  3. Recommendations
  4. Research Agenda
  5. Strategies needed for implementation of recommendations

Work Group members: Rowland Chang, MD, Northwestern University, Evanston, Illinois, (Chair); Ronenn Roubenoff, MD, MHS, Jean Mayer, USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts; Kenneth D. Brandt, MD, Indiana University/Purdue University at Indianapolis, Indiana; Laura E. Schanberg, MD, Duke University Medical Center, Durham, North Carolina.

Recommendations

  1. Top of page
  2. Session IV, Exercise in the Presence of Rheumatic Disease
  3. Recommendations
  4. Research Agenda
  5. Strategies needed for implementation of recommendations
  • Some level of physical activity is necessary for the maintenance of joint health for both normal and arthritic joints.

  • Strengthening, flexibility, and aerobic exercises may be helpful to reduce pain and improve function in arthritis.

  • Programs to increase physical activity and reduce body weight are important in the prevention and treatment of overweight patients with lower extremity osteoarthritis.

  • Programs to teach patients how to strengthen muscle and protect joints, without excessively loading joints, should be implemented.

  • Patients with rheumatoid arthritis have specific nutritional and exercise needs to counteract the cachexia of chronic inflammation.

  • Educate health professionals, health care organizations, and policy makers concerning the high prevalence of musculoskeletal pain and the need for effective management in children.

Research Agenda

  1. Top of page
  2. Session IV, Exercise in the Presence of Rheumatic Disease
  3. Recommendations
  4. Research Agenda
  5. Strategies needed for implementation of recommendations
  • Study the reversal of cartilage atrophy following periods of immobility to answer questions regarding when to initiate reloading and the appropriate dose of reloading.

  • Determine effects of selective COX-2 inhibitors on the recovery from cartilage atrophy after periods of immobilization and interactions with reloading.

  • Investigate effects of electrical stimulation of muscle on the prevention or recovery from cartilage atrophy and osteoporosis after periods of immobilization.

  • Determine if exercise is beneficial in the prevention, or reduction in progression, of radiographic osteoarthritis.

  • Determine if exercise is beneficial in the prevention and/or progression reduction of symptomatic osteoarthritis.

  • Study the molecular/cellular mechanisms by which exercise reverses the cachexia of chronic inflammation.

  • Identify the effect of cytokine inhibitors on the control of cachexia of chronic inflammation.

  • Clarify the scope of pain experiences in children with arthritis.

Strategies needed for implementation of recommendations

  1. Top of page
  2. Session IV, Exercise in the Presence of Rheumatic Disease
  3. Recommendations
  4. Research Agenda
  5. Strategies needed for implementation of recommendations
  • Position statement from the American College of Rheumatology in favor of strength training and aerobic exercise (distinct from symptom-directed physical and occupational therapy) as routine, comprehensive care of all patients with inflammatory diseases.

  • Increase awareness of evidence-based exercise and physical activity programs.

  • Educate primary care providers and their health care organizations.

  • Strengthen the funding to enhance the health-promotion science base regarding exercise and arthritis.

  • Large-scale public awareness campaign.

  • Coordination of existing exercise and physical activity promotions (Arthritis Foundations, Centers for Disease Control and Prevention, etc.).