Cours 13 : Arthritis

Question 1

What is the typical clientele?

Answer 1

Older adults

18-44 : 7% report doctor-diagnosed arthritis

45-64 : 30% report doctor-diagnosed arthritis

aged 65 or older : 50% report doctor-diagnosed arthritis

More females than males : 26% of women and 19% of men report doctor-diagnosed arthritis

Question 2

Can a kinesiologist play a role?

Answer 2

Yes, we deal with more aging population, so arthritis is one of them and moving is one of the treatments of arthritis

Question 3

What about glucosamine? Is it better than a fake pill?

Answer 3

No, it is not better

Question 4

What is the definition of arthritis?

Answer 4

From greek - arthro = joints + tis = inflammation (a group of conditions where there is damage caused to the joints of the body

Question 5

How many forms of arthritis there is?

Answer 5

More than 100 forms of arthritis –> these include conditions characterized by soreness, stiffness and pain in joints

Examples from the Arthritis Society site

Question 6

What is the most common form of arthritis?

Answer 6

Rheumatoid arthritis (+- 1% of the population)

Osteoarthritis (+- 10% of the population)

Question 7

What are the main problems of arthritis?

Answer 7

Decrease in joint mobility

Presence of joint pain

Question 8

What is the prevalence of arthritis?

Answer 8

6 million Canadians have arthritis (1 in 7 people)

The most common cause of long-term disability in Canada

More than 600 000 Canadians are classified as disabled because of arthritis ( no work and decrease in daily living activities)

Question 9

Why is the prevalence going up?

Answer 9

Because of the aging population. It will increase economic costs to society and the proportion of the population who experience the pain, disability and disruption to their lives due to arthritis

Question 10

What is the impact of arthritis on daily life?

Answer 10

The pain can prevent activities in people living with arthritis

Physical inactivity is slightly higher in people living with arthritis

** Physical activities like gardening, snow shovelling, cleaning the house,etc**

Question 11

What is the hand involvement in arthritis?

Answer 11

Inflammation and joint deformity (with time and if its severe)

It can be painful

Question 12

What is rheumatoid arthritis?

Answer 12

Affects all ages with usual onset between 20 and 50 years ( approximately 272 000 Canadians

3 times more common in females

inflammation occurs in the synovial membranes that cover a joint capsule and spreads throughout the joint

Affects more than one joint and usually symmetrical

Most common on the wrist, hands, knees, feet, cervical spine

Periods of exacerbation (flare up) and remission

Question 13

What is Rheumatoid Arthritis (disease type and cause)?

Answer 13

Systemic = the entire body is affected (fever, pallor, inflammation of tear and salivary glands

Medication to reduce joint inflammation and pain + immunosuppressive drugs

Cause : malfunction of the immune system (autoimmune disease)

New = blood test for RA diagnosis (inflammatory markers = c reactive protein)

C- reactive protein is a protein produced by the liver and found in blood. CRP levels in the blood rise in response to inflammation

Question 14

What happens in the joints with Rheumatoid Arthritis?

Answer 14

There’s an inflamed joint capsule and synovial membrane

There’s panes formations (swelling from the synovial membrane), loss of space in synovial cavity and there’S cartilage destruction

T-cells don’t recognize it anymore so the body attacks by producing new cells and repair the injuries but it creates deformation

Question 15

What is Juvenile Rheumatoid Arthritis?

Answer 15

The most common form of arthritis in children

Symptoms and causes are similar to those of rheumatoid arthritis

Average age of onset : 6 years
(2 peaks of 2-4 and 8-11)

Complete functional recovery in about 50% of the cases

Periods of exacerbation last form 1 week to several months

Question 16

What are the warning signs of Rheumatoid Arthritis?

Answer 16

Pain, swelling, tenderness, heat, or redness in a joint. This is called inflammation

Inflammation may start gradually or with sudden severe attack (can occur after psychological trauma)

Morning stiffness that lasts longer than 30 minutes

Pain in 3 or more joints at the same time or in a joint all night Lon

Low energy and fatigue (systemic disease)

Question 17

What is osteoarthritis?

Answer 17

The most common form of arthritis

Mainly affects persons age 50+

Same incidence between men and women

Symptoms get worse as the day goes on (because of fatigue)

Degenerative joint disease (loss of articular cartilage)

Commonly affected joints, hands, spine, hips, knees

Disease the = peripheral (local effect)

Medications to reduce joint inflammation and pain

Causes : genetic predisposition, joint trauma (Kees of football players), excess weight (obesity), overuse syndrome (hands of hairdressers)

Question 18

What are the treatment to manage arthritis?

Answer 18

Exercise helps reduce pain, and prevent further joint damage

Mechanical pressure over the cartilage = brings nutrients + squeezes out waste

Absences of movement = cartilage will starve + crumble away and tendons + ligaments will shrink, stiffen up + become weaker

Exercise of inflamed joints straightens the muscles around the joint. This results in less pain + exercise helps you maintain a healthy weight, which puts less strain on the joints (weight bearing joints)

Question 19

What does the program look like?

Answer 19

2 fitness assessments (pre and post 12 week session)
- Resting heart rate and blood pressure
- Height and weight
- Waist circumference
- Percent of body fat and fat free mass
- aerobic testing

Each class is once a week
- aerobic training
- resistance training
- range of motion
- stretching muscle relaxation or an educational talk

Question 20

What is a RED workout?

Answer 20

More than normal pain + joints in flare-up –> training intensity = low (rest and recover + range of motion and breathing + relaxation exercises stretching

Question 21

What is a YELLOW workout?

Answer 21

Normal pain + normal joint comfort

Training intensity
Easy to moderate = normal exercise routine

Question 22

What is a GREEN workout?

Answer 22

Better than normal pain + joints feeling good

Training intensity
Moderate to high (baby seps)
Trying something new with increase time, weights, reps and sets

Question 23

What are the exercise recommendations from the Arthritis Society?

Answer 23

Range of Motion + Stretching
If joint is affected but not painful
ROM exercise : 5-10 repetitions, the positions is held for 2-3 seconds (when it is appropriate)
- Stretching exercises : 2 to 3 repetitions, the position is held for 20-30 sec

If the joint is slightly swollen , but neither hot nor painful, cut the repetitions in half

if the joint is hot, swollen + painful : 1 or 2 receptions, of the ROM exercises and no stretching

Question 24

What are the Stretching exercises?

Answer 24

5-10 repetitions with low pad (it can be repeated 3 times = 15 to 30 reps)

If the joint = slightly swollen + mildly painful = cut the repetitions in half = 7 to 15 reps

If the joint is hot, swollen + painful = avoid strengthening exercises

Important to move the affected joints

Question 25

What is relaxation?

Answer 25

Relaxing the muscles around an inflamed joint reduces pain. Stress/Anxiety - will increase pain sensation

Heat/Cold
Heat helps relax aching muscles, reduces joint pain and soreness (not recommended for swollen joints) ex : take a hot shower, hot pad

Cold helps lessen the pain and swelling in joint ex: put an Ince pack on your knee

Question 26

What is joint protection?

Answer 26

To prevent joint deterioration = important to be kind to the body. After doing heavy work, or doing the same task over and over, stop or slow down

Important to use arms, legs and back in safe ways to avoid stress on joints

ex: carry a heavy load close to your body