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      Benefits of Exercise in Rheumatoid Arthritis

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          Abstract

          This paper aims to highlight the importance of exercise in patients with rheumatoid arthritis (RA) and to demonstrate the multitude of beneficial effects that properly designed exercise training has in this population. RA is a chronic, systemic, autoimmune disease characterised by decrements to joint health including joint pain and inflammation, fatigue, increased incidence and progression of cardiovascular disease, and accelerated loss of muscle mass, that is, “rheumatoid cachexia”. These factors contribute to functional limitation, disability, comorbidities, and reduced quality of life. Exercise training for RA patients has been shown to be efficacious in reversing cachexia and substantially improving function without exacerbating disease activity and is likely to reduce cardiovascular risk. Thus, all RA patients should be encouraged to include aerobic and resistance exercise training as part of routine care. Understanding the perceptions of RA patients and health professionals to exercise is key to patients initiating and adhering to effective exercise training.

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          Most cited references136

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          Evidence for prescribing exercise as therapy in chronic disease.

          Considerable knowledge has accumulated in recent decades concerning the significance of physical activity in the treatment of a number of diseases, including diseases that do not primarily manifest as disorders of the locomotive apparatus. In this review we present the evidence for prescribing exercise therapy in the treatment of metabolic syndrome-related disorders (insulin resistance, type 2 diabetes, dyslipidemia, hypertension, obesity), heart and pulmonary diseases (chronic obstructive pulmonary disease, coronary heart disease, chronic heart failure, intermittent claudication), muscle, bone and joint diseases (osteoarthritis, rheumatoid arthritis, osteoporosis, fibromyalgia, chronic fatigue syndrome) and cancer, depression, asthma and type 1 diabetes. For each disease, we review the effect of exercise therapy on disease pathogenesis, on symptoms specific to the diagnosis, on physical fitness or strength and on quality of life. The possible mechanisms of action are briefly examined and the principles for prescribing exercise therapy are discussed, focusing on the type and amount of exercise and possible contraindications.
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            Barriers and motivations to exercise in older adults.

            Although exercise is an established component in the management of many chronic diseases associated with aging, activity levels tend to progressively decline with increasing age. Given the growing proportion of older adults, these suboptimal levels of physical activity represent an increasing public health problem. The predicators of adherence elucidated in younger adults are unreliable in elderly populations. Age-specific barriers and motivators unique to this cohort are relevant and must be acknowledged. The identification of reliable predictors of exercise adherence will allow healthcare providers to effectively intervene and change patterns of physical activity in sedentary elderly. In particular, because older patients respect their physician's advice and have regular contact with their family doctor, physicians can play a key and pivotal role in the initiation and maintenance of exercise behavior among the older population.
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              The assessment of fatigue: a practical guide for clinicians and researchers.

              Fatigue is a common feature of physical and neurological disease as well as psychiatric disorders, often reported amongst patients' most severe and distressing symptoms. A large number of scales have been developed attempting to measure the nature, severity and impact of fatigue in a range of clinical populations. The aim of the present review is to guide the clinician and researcher in choosing a scale to suit their needs. Database searches of Medline, PsycINFO and EMBASE were undertaken to find published scales. Details of 30 scales are reported. These vary greatly in how widely they have been used and how well they have been evaluated. The present review describes the scales and their properties and provides illustrations of their use in published studies. Recommendations are made for the selection of a scale and for the development and validation of new and existing scales.
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                Author and article information

                Journal
                J Aging Res
                JAR
                Journal of Aging Research
                SAGE-Hindawi Access to Research
                2090-2204
                2090-2212
                2011
                13 February 2011
                : 2011
                : 681640
                Affiliations
                1School of Sport, Health and Exercise Sciences, Bangor University, George Building, Holyhead Road, Bangor, Gwynedd LL57 2PZ, UK
                2Department of Rheumatology, Llandudno Hospital, Betsi Cadwaladr University Health Board, Llandudno, LL30 1LB, UK
                Author notes
                *Jeanette M. Thom: j.thom@ 123456bangor.ac.uk

                Academic Editor: Ben Hurley

                Article
                10.4061/2011/681640
                3042669
                21403833
                5463452f-65fa-4207-b93f-e638233d1e2c
                Copyright © 2011 Jennifer K. Cooney et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 September 2010
                : 15 December 2010
                Categories
                Review Article

                Molecular medicine
                Molecular medicine

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