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July 28, 2006 -- Move it or lose it is good advice for people with arthritisarthritis, but far too few exercise regularly even though they know they should.
In an effort to find out why, researchers from the University of South Carolina polled arthritis patients who did and did not engage in regular exercise. They found that attitudes, motivation, and medical support all played a role in whether patients remained active or became sedentary.
Both exercisers and nonexercisers with arthritis commonly reported feeling pain when they were physically active. But the exercisers were more likely to believe that their short-term pain would lead to longer-term benefits.
Nonexercisers often reported that they were not physically able to exercise because of their arthritis.
"Many of the nonexercisers in our study actually did exercise regularly before they developed arthritis," researcher Sara Wilcox, PhD, tells WebMD. "Instead of modifying their exercise routines when they began to experience pain, they gave up."
Those who continued to exercise were more willing to change their routines and work through the pain, she says. A jogger who developed knee osteoarthritisosteoarthritis, for example, might switch to a walking program to get the benefits of exercise with less impact.
Barriers and Benefits
Doctors now know that staying active through regular exercise is one of the best things people with arthritis can do to slow the progression of their disease, improve physical functioning, and even reduce pain over the long term.
Stretching, strength, and aerobic exercise all help patients in different ways, but studies show that people with arthritis are less likely to exercise than people without arthritis problems.
Wilcox and colleagues polled 68 arthritis patients who participated in different focus groups to better understand their perceptions about the barriers and benefits of exercise.
Their research was supported by the CDC. It was first published in the June 15 edition of Arthritis & Rheumatism and will be published in the August issue of Arthritis Care & Research.
Information Shortfall?
In addition to pain -- and fear of pain -- the most often cited barriers to exercise were a lack of support by doctors and a feeling that there were no appropriate programs or facilities that met their unique needs.
"Many patients said their doctors either didn't discuss exercise with them at all, or only did so in very general terms," Wilcox says. "Patients were told that exercise was good for them, but they weren't told what kind of exercises to do."
She says health care providers should prescribe specific exercise programs geared toward the individual patient's needs and abilities. Patients should also be referred to exercise facilities or exercise professionals who understand arthritisarthritis.
"One person talked about going to a personal trainer who knew nothing about arthritis and being in pain for days afterwards, because the trainer pushed them way too hard," she says.
Not Just Bones and Joints
University of Texas Health Science Center chief of rheumatology Bernard Rubin, DO, MPH, tells WebMD that arthritis patients often cite many of the same reasons for not exercising as people without arthritis.
"They tell me they are too busy or they are too tired at the end of the day," he says. "They see exercise as a monumental task and it is our job to make them understand how important it is."
Studies show that patients who engage in regular exercise maintain their mobility, physical functioning, and even independence longer than those who don't.
"Arthritis isn't just about the bones and joints," he says. "It is also about the muscles, tendons, and ligaments. All of these things work together to help you walk or get up out of a chair. If you don't exercise you quickly become deconditioned and less able to function."
SOURCES: Wilcox, S. Arthritis & Rheumatism, June 15, 2006; vol 55: online edition. Sara Wilcox, PhD, associate professor of exercise science, Arnold School of Public Health, University of South Carolina, Columbia. Bernard Rubin, DO, MPH, professor of medicine and chief of the division of rheumatology, University of North Texas Health Sciences Center, Fort Worth.