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Getting exercise not easy for folks with arthritis

ArthritisJul 27, 06

The benefits of exercise for people with arthritis are well established. However, arthritis patients say they face a number of barriers to continued physical activity, including a dearth of specialized exercise programs, a focus-group study shows.

“The people in our groups talked a lot about lack of programs for people with arthritis,” Dr. Sara Wilcox of the University of South Carolina in Columbia told Reuters Health. “They were interested in programs where they could be active with other people that had arthritis and professionals that understood the disease. They also perceived that they didn’t get a lot of physician support to be active.”

Arthritis patients who did keep exercising were more likely to have adjusted their activities to their physical limitations, while those who did not tended to give up in the face of such barriers, Wilcox and her colleagues found.

Exercise can ease pain and improve mobility for people with arthritis, although pain can increase temporarily during and after exercise, Wilcox said in an interview. Safe exercise for people with arthritis can include walking, water aerobics, and moderate strength training, she added.

Arthritis patients are known to be less likely to exercise than people in the general population. To learn why, Wilcox and her team conducted 12 focus groups with 68 adult arthritis patients, 36 of whom exercised.

Somewhat more of the participants had osteoarthritis, the wear-and-tear kind of joint damage, rather than rheumatoid arthritis—although about 20 percent didn’t know what type they had.

The obstacles to exercise reported by the exercisers and non-exercisers were quite similar, with pain being the most frequently discussed, the researchers note in the June 15 issue of Arthritis & Rheumatism. Other barriers included fatigue, mobility impairment, fear of pain during and after exercise, lack of exercise programs and facilities specifically designed for people with arthritis, and damp and rainy weather—which aggravates arthritis symptoms.

Study participants also said their doctors provided them with little information or advice on exercise. However, non-exercisers were more likely to say that having no one to exercise with was a barrier to exercise participation, and were more likely to report being afraid of the water, which barred them from participating water aerobics.

Nearly all study participants, whether they exercised or not, agreed that exercise could reduce pain and increase mobility and function. Exercisers were also more likely to say that the desire to remain independent motivated them to exercise.

The findings have clear implications for how exercise should be promoted to people with arthritis, and how physicians and communities can make it easier for arthritis patients to exercise, Wilcox and her team say. Physicians probably need more help in advising their patients on exercise, and more arthritis-specific programs are clearly needed, they add.

Given that non-exercisers were more likely to have given up on physical activity rather than adjusting their workouts to fit their limitations, the researchers note, “messages might be more effective if they emphasize ways in which individuals with arthritis can modify exercise to accommodate their disease.”

Also, they add, programs based on knowledge alone may not be enough to get non-exercisers moving; special training including problem-faced coping skills may be necessary.

SOURCE: Arthritis & Rheumatism, June 15, 2006.

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