1999 Volunteer Leadership Training Guide
Managing Arthritis
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Introduction
• Objectives
• Target Audiences
• Major Teaching Points
• Exercise is Essential
• Designing Your Program
• Activity Goals
• Additional Resources
• Suggested Activities
• Handouts
Introduction
Arthritis is the number one cause of disability in America. One in seven
persons, or approximately 40 million Americans, has some form of arthritis. By
2020, an estimated 60 million people will have arthritis. The costs for medical
care and lost productivity amount to an estimated $65 billion annually.
Arthritis strikes people of all ages. Women are at special risk, accounting
for almost two-thirds of all arthritis cases.
Objectives
1. Participants will learn how to take control of their arthritis.
2. Participants will learn how to design an exercise program that's
appropriate for them.
3. Participants will learn reliable sources of information on arthritis.
Target Audiences
EHC members
Adults
Arthritic adults
Major Teaching Points
Understanding Arthritis
1. Arthritis is not one single disease. There are over 100 forms of
arthritis.
2. The best known symptoms of arthritis include joint pain, a sense of
discomfort after rest or inactivity and stiffness.
3. Arthritis disorders frequently affect more than joints. Some forms
can affect body organs and can threaten life.
Causes of Arthritis
1. Most of the underlying causes of arthritis are unclear. Physical
trauma can set the stage for osteoarthritis, the most common form of
arthritis.
2. Other causes include lack of physical activity, excessive weight or
a joint defect, genetic factors, the environment, infectious agents and
an imbalance of certain enzymes. Stress or emotional trauma can worsen
symptoms.
3. The various forms of arthritis may be associated with the following:
Forms of Arthritis
1. The majority of arthritic patients have one of two forms --
osteoarthritis or rheumatoid arthritis.
2. Osteoarthritis affects about 20 million Americans and is most common
in women.
3. Symptoms include:
- Pain in a joint during or after use
- Discomfort in a joint before or during a change in the weather
- Swelling and stiffness in a joint, particularly after using it
- Bony lumps on the middle or end joints of the fingers or the
base of the thumb
- Loss of flexibility of a joint
4. Rheumatoid arthritis can strike at any age, but often develops
between 20 and 50 years of age. It affects an estimated 2 million
Americans, twice as many women as men.
5. Symptoms include:
- Pain and swelling in the smaller joints of the hands and feet
- Overall aching or stiffness of the joints and muscles,
especially after sleep or rest
- Loss of motion of the affected joints
- Loss of strength in muscles attached to the affected joints
- Deformity of the joints as time passes
- Fatigue (severe during a flare-up)
Joint Protection
1. One of the most effective ways to preserve and protect your joints
is through proper exercise.
2. Exercise can:
- Strengthen muscles surrounding arthritic joints
- Increase joint flexibility and range of motion
- Reduce fatigue
- Increase energy levels
- Help you lose weight
- Improve sleep
3. Before you engage in any physical activity, you need to know the
basic principles of joint protection. These include:
- Seek medical advice -- If you aren't physically active or
if you're not sure what kind of activity is beneficial or
appropriate, consult your doctor. The doctor may refer you to an
occupational or physical therapist.
- Start slowly -- Move each joint through its full
pain-free range of motion at least once daily.
Gently stretch muscles of affected joints at least once daily,
perhaps when you awaken in the morning and definitely at the beginning
and end of any exercise. Stretching loosens muscles and reduces risk of
injury. Slow and gentle stretching can increase a stiff joint's range of
motion.
- Warm up and cool down -- Warm up your joints and muscles
by gently walking in place for a few minutes; using a heating pad or
hot pack; taking a warm bath or shower. Do not apply heat to an
already warm, swollen joint. After exercise, apply cold to the
affected joints for 10-15 minutes.
- Increase the pace gradually -- Start where you are -- at
a comfortable level. Then increase your exercise level as you
progress.
- Learn the difference between discomfort and pain from overuse
-- Adjust your level of activity to avoid excessive pain. Don't
over-exercise tender, injured or badly inflamed joints.
- Know your limits -- If you have osteoarthritis of the hip
or knee and the bones and cartilage of the affected joints aren't
too worn down, then a relatively high-impact activity such as
walking is ok. If the bones and cartilage are significantly worn
down, walking can cause more damage. Then, swimming would be a
better option.
If you have rheumatoid arthritis, low-impact activities are
better, depending on the amount of wear and tear on joints affected
by the arthritis. If the joint is not painful and the activity isn't
painful, it's probably ok to continue. If the activity causes pain,
stop and select an alternative exercise.
- Rest -- There's a delicate balance between being active
and resting. There will be times when you'll need to rest to
conserve energy. At other times, you'll need to exercise to maintain
the strength of your muscles, nourish your joints, stay reasonably
flexible and build your energy.
There are two kinds of rest -- joint rest and whole-body rest.
Using an affected joint helps keep it healthy and promotes the
supply of nutrients and oxygen to the joint. If a particular muscle
or joint seems tired, that's a signal to rest.
If you have arthritis, especially rheumatoid arthritis, a
well-rested body is an important goal to achieve daily. Inflamed
joints makes you vulnerable to fatigue. If you experience a flare or
joint inflammation, you need to schedule more rest time.
If you're exhausted, you may not feel like doing anything.
However, if you don't get enough physical activity, your muscles
will get weaker and physical activity will be more difficult to do.
The key is to pace yourself.
Exercise Is Essential
1. Physical activity is essential to health.
2. Aerobic exercise increases cardiovascular fitness.
3. Cardiovascular health is complex -- it's more than how hard your heart
pumps and how well you breathe. It involves how well your muscles and
tissues take oxygen from the blood. It includes the density of the small
blood vessels that feed your tissues (capillaries).
4. Body composition affects cardiovascular health.
5. So does your body's ability to handle fat or fat-like substances found
in your blood (lipids).
6. Prolonged bed rest or inactivity aggravates these functions and leads
to poor cardiovascular health. Inactivity causes reduced circulation in the
legs. It also decreases the body's ability to extract oxygen from the blood.
7. Lack of exercise makes the bones less dense and causes muscles to
become weakened and lose flexibility.
8. Exercise is part of the solution for the most frequent complaints of
people with arthritis. Arthritics say pain is their number one problem.
Appropriate types and amounts of exercise help reduce arthritic pain.
9. Fatigue is the second most common complaint of arthritics. Adequate
rest and aerobic conditioning is the prescription for fatigue.
10. A sensible exercise program can reduce the risk of cardiovascular
disease and increase endurance.
11. It can slow bone loss that leads to thinning of the bones
(osteoporosis).
12. Appropriate exercise increases flexibility and strengthens the
muscles that help stabilize the joints.
13. It reduces morning stiffness and maintains mobility. It improves
balance and increases endurance.
14. It can help control weight.
15. Exercise also boosts your psychological well-being.
Designing Your Program
1. Learn to pay attention to your body to determine what level of
activity is appropriate for you. Know how you feel as you begin an activity.
Note how you feel when you finish the activity.
2. An activity level that's appropriate for you should make you feel the
same or better afterward. If you feel worse, you're doing something wrong.
3. Before you change your exercise program, have a thorough physical
examination and discuss your plans with your doctor. Determine if you need
to consult with a physical or an occupational therapist.
4. Your program should include activities you enjoy.
5. Walking is a good way to start and excellent for overall conditioning.
6. Include activities daily to improve flexibility. Stretching and
range-of-motion exercises counteract stiffness in major joints and spine.
7. Moderate, regular exercise is the emphasis of new guidelines from the
Centers for Disease Control and Prevention, the American Heart Association,
the American College of Sports Medicine and others. The frequency and
duration of the activity is more important than the intensity.
Activity Goals
1. Guidelines recommend at least 30 minutes of low to moderately
intense physical activity most days.
2. Be creative. Schedule exercise into your day. You can benefit from
short periods of activity -- 5-10 minute intervals that add up to at
least 30 minutes. The key is the total amount of energy expended, not
the intensity. If you can't carry on a conversation or you experience
severe pain while exercising, you're pushing too hard.
Additional Resources
Arthritis Foundation, 6213 Lee Avenue, Little Rock, AR 72205,
501-664-7242
Arthritis Foundation, 1330 West Peachtree Street, Atlanta, GA
30309, 404-872-7100
Arthritis Answers, 800-283-7800, to order brochures, subscribe to
magazine Arthritis Today
Arthritis: A Take Care of Yourself Health Guide for Understanding
Your Arthritis by James F. Fries, M.D.
Mayo Clinic Health Oasis Web Site
Arthritis Foundation Web Site
Department of Health and Human Services Web Site
National Institute of Arthritis and Musculoskeletal and Skin Disorders Web
Site
Healthinfo
Clinical
American
Medical Association Web Site
American College of Rheumatology Web Site
Suggested Activities
1. Have the participants do some of the recommended exercises. Refer to
the handout, Recommended Exercises.
2. Have the participants begin a walking program, starting at their
present level of fitness.
3. Have the participants research arthritis information listed under the
heading, "Additional Resources."
Handouts
1.
Managing Arthritis
2.
Recommended Exercises
Charlotte Mills Fant, Extension Health Education Specialist
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