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Rheumatoid Arthritis and Aerobic Exercise

Physical Therapist's Viewpoint

As a physical therapist for over 30 years, I have seen our treatment of arthritis and expectations of treatment change dramatically. Probably the greatest impact in the last 15 years has come from the positive results from research on exercise and arthritis and the advances in drugs used to treat a number of rheumatic diseases. As we have learned more about the feasibility and benefits of conditioning exercise for people with many different types of arthritis, we also have developed safe and effective drugs to stop inflammation and slow or stop the progression of disease. We can't cure arthritis, yet, but good medical care combined with exercise and education for self-management go along way toward decreasing the loss of function and disability we used to think was inevitable.

When I started as a PT, we barely knew the pathogenesis of rheumatoid arthritis and didn't even think that osteoarthritis could be managed. The most we had for treatment were range of motion exercises and thermal modalities. It was disheartening to have so little to offer. Now there is so much that can be done. Our challenge today is to encourage people to seek good professional care early and to start effective disease management without delay.

We now know that people with arthritis can improve flexibility, endurance, strength and cardiovascular fitness with regular exercise. Their arthritis does not get worse with increased activity. In fact, regular exercise appears to have a positive effect on disease-related problems such as joint swelling, morning stiffness, pain, depression and lost function. Appropriate exercise and maintenance of adequate levels of physical activity are important components of improved outcomes and are well within the scope of self-management. All people with arthritis should be told about the importance of exercise, and provided appropriate information and ongoing support to become successful exercise self-managers. We know too much about the safety and benefits of exercise to not make it a part of everyone's comprehensive care.