# Exercise as it relates to Disease/Effects of Exercise Programs on Functional Fitness for Older Adults with Arthritis

This is an analysis of the journal article "Effects of Arthritis Exercise Programs on Functional Fitness and Perceived Activities of Daily Living Measures in Older Adults With Arthritis" by Suomi & Collier (2003)

## What is the background to this research?

Arthritis is a very common condition all over the world affecting people of all ages and from all walks of life. Arthritis is often mistaken as being just a single disease, in fact it is a branch of over 100 conditions which affect the musculoskeletal system. Whilst there are over 100 different cases of Arthritis, three account for 95% of patients diagnosed in Australia. The three most common are osteoarthritis, rheumatoid arthritis and gout. Arthritis is a condition which is not yet curable, although can be managed through exercise programs to maintain range of movement and isometric strength.
Despite the known benefits of exercise for patients with arthritis, it is particularly difficult to motivate them to initiate or even adhere to an exercise program. Nearly 44% of older adults with arthritis report no physical activity. Lack of physical activity is a risk factor for other chronic diseases and can also interfere with the management of other medical conditions. A seven step approach was created by Resnick (1999) to help motivate older adults to exercise. This approach addresses all of the barriers mentioned by older adults as decreasing their adherence to exercise programs. The seven steps are as follows;
* Education
* Exercise Prescreening
* Setting Goals
* Exposure to Exercise
* Exposure to Role Models
* Verbal Encouragement
* Verbal Reinforcement/Rewards
Despite all of the known benefits of exercise for people with arthritis, motivating older adults to initiate and continue regular exercise programs is difficult. Throughout this seven step approach older adults are guided to overcome barriers to exercise and improve exercise activity.

## Where is the research from?

Suomi and Collier from the school of health, exercise science and athletics. University of Wisconsin, Stevens Point, WI. Subjects were recruited through newspaper advertisements and flyers to area physicians.

## What kind of research was this?

This is a quantitative research study, involving collection of data and analysis through the use of statistics to help explain the findings.

## What did the research involve?

The research involved a newspaper article advertising an exercise program for older adults with arthritis. To be eligible to undertake in this study, participants had to be between the ages of 60 and 79 and a diagnosis or rheumatoid arthritis or osteoarthritis. Once eligible, participants were split into 1 of 3 groups; Control, on-land exercise and aquatic exercise. Exercise programs ran for a total of eight weeks. Assessments were completed before commencing the study such as; flexibility, balance, mobility, strength and endurance tests.

## What were the basic results?

Suomi & Collier (2003) found significant results across all categories. Compliance rates came in at 79% and 90% for aquatic and on-land exercises respectively. Isometric strength measures were seen to have an increase from 11.8% to 18.6% for 3 out of 4 aquatic groups and all 4 of the on-land groups. Functional fitness measures also saw a significant increase for; hand-eye coordination, flexibility and arm curl. Although through this, no increases were seen in cardiorespiratory endurance.

## What conclusions can we take from this research?

Research has shown that both aquatic and on-land exercise programs can show improvements in functional fitness and activities of daily living measures for older adults with arthritis. Each exercise program has different benefits and on-land was seen to have higher compliance rates as getting in and out of a pool can sometimes be difficult for older adults. Further research should be done on the adherence of older adults with arthritis to exercise programs and what benefits these programs can provide to sufferers of arthritis.

## Practical advice

For patients with arthritis there are a number of things that can be done to manage symptoms and increase overall quality of life;
* Control weight gain to ease pressure on joints
* Use a physiotherapist to increase your range of movement
* Ensure good posture to help strengthen joint structure
* Avoid stress or injury to your joints
It is important to maintain a healthy lifestyle especially when suffering from arthritis. It is recommended that older adults with arthritis undertake in at least 150 minutes of moderate physical activity/week.

## Further Information/Resources

For further information on the benefits of fitness on older adults with arthritis, click on the following links below;
* Managing Arthritis with exercise: http://www.gnjournal.com/article/S0197-4572(01)20453-4/abstract
* Cardiovascular Disease, Rheumatoid Arthritis and physical activity: http://rheumatology.oxfordjournals.org/content/47/3/239.full.pdf+html
* Efficacy of physical conditioning on patients with rheumatoid arthritis: http://onlinelibrary.wiley.com/store/10.1002/anr.1780321108/asset/1780321108_ftp.pdf;jsessionid=457D00A1A68B8937D829DAC553324344.f04t01?v=1&t=itbhl8qr&s=e2c7f05df5d68e174610965c42f0ad74ae28380a
* Arthritis - symptoms and care: http://www.aplaceformom.com/senior-care-resources/articles/arthritis-information

## References

* 1 2 3 4 5 Suomi R, Collier D. (2003) 'Effects of Arthritis Exercise Programs on Functional Fitness and Perceived Activities of Daily Living Measures in Older Adults with Arthritis'. Arch Phys Rehabil Vol 84: pp 1-6.
* ↑ Arthritis Australia (2012). Welcome arthritis to Australia. Available from: http://www.arthritisaustralia.com.au
* 1 2 3 Arthritis Australia (2012). What is Arthritis. Available from: http://www.arthritisaustralia.com.au/index.php/arthritis-information.html
* 1 2 Ettinger SH, Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. JAMA 1997;277:25-31.
* ↑ Sullivan T, Allegrante JP, Peterson MG, Kovar PA, MacKenzie CR. One- year follow-up of patients with osteoarthritis of the knee who participated in a program of supervised fitness walking and supportive patient educa- tion. Arthritis Care Research 1998;11:228-33.
* 1 2 Centers for Disease Control and Prevention (2016). Arthritis. Available From: http://www.cdc.gov/chronicdisease/resources/publications/aag/arthritis.htm
* 1 2 Resnick B. Exercise for the older adult: the seven step approach to wellness. Advance Nurses 1999:20.
* 1 2 Resnick, B. (2001). Managing arthritis with exercise. Geriatric Nursing, 22(3), 143-150.
* ↑ Health Direct (2016). Living With Arthritis. Available From: https://www.healthdirect.gov.au/living-with-arthritis