Introduction
Rheumatoid arthritis (RA) is a chronic and systemic condition that occurs in form of chronic joint inflammation, which is characterized by serious limitations among patients in terms of movement due to pain and fatigue. According to the World Health Organization, rheumatoid arthritis affects approximately 1.6% of the population in the world, which serves as a clear indication of the need for effective management approaches. Persons over the age of 40 years are at a higher risk of contracting or suffering from rheumatoid arthritis with the women experiencing up to 5 times the risk of the condition when compared to the men. Most of the persons suffering from rheumatoid arthritis experience impaired physical functionality taking into account that this condition affects the functioning of the joints, which are key towards determining different movements in the body.
A significant number of the patients suffering from rheumatoid arthritis experience an accelerated loss of muscle mass, which is a condition that is known as rheumatoid cachexia . The occurrence of this condition creates a situation where patients find themselves experiencing a significant reduction in the quality of life. The main contributors to rheumatoid cachexia are hypermetabolism and protein degradation occurring within the body system, which serves as a clear indication of the need for having to set effective measures to deal with the issue. On the other hand, studies have also pointed to the fact that rheumatoid cachexia may also occur as a result of poor nutritional intake and reduced engagement in physical exercises. That serves as a clear indication of the need for having to come up with programs that would seek to ensure that these patients engage in exercises.
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Regarding the issue of exercises, one of the key aspects to note is that lack of engagement in physical activities occurs as a key contributor to the high risk of rheumatoid arthritis. That means that in the event that persons do not engage in physical activities, the risk of rheumatoid arthritis increases significantly. Ettinger et al. (1997) argue that approximately 80% of patients suffering from rheumatoid arthritis do not engage in any form of physical activities and exercises, which serves towards increasing the risks that they face with regard to the condition. Physical inactivity occurs as a characteristic in which patients expose themselves to serious health risks not only with regard to rheumatoid arthritis but also when dealing with other health conditions. Ultimately, this has created the need for having to ensure that patients with rheumatoid arthritis engage in more physical activities as part of their management and treatment approaches focusing on this chronic condition.
Cardio and resistance exercises have been considered as key towards defining the overall possibilities of maximizing on the need for patients to improve on their engagement in physical activities. These exercise and training programs seek to ensure that the patients are able to build on their overall capacities to maximize on their health outcomes while advancing overall possibility of avoid a wide array of medical issues. The main purpose of this research paper is to highlight some of the underlying benefits that can be associated with engagement in cardio and resistance training as a way of improving physical activity among patients with rheumatoid arthritis. The paper seeks to highlight the effects that cardio and resistance training would have in the treatment and management of rheumatoid arthritis.
Benefits of Cardio and Resistance Training in Rheumatoid Arthritis
Training and exercises have been shown to have significant benefits for patients suffering from rheumatoid arthritis. In majority of studies that have sought to examine management and treatment measures for rheumatoid arthritis, one of the key recommendations revolves around ensuring that these patients would embark on effective exercising. Specifically, it becomes important for these patients to embark on cardio and resistance training as part of their approaches towards ensuring that they are able to maximize on management practices. The benefits that cardio and resistance training would have for patients with rheumatoid arthritis include enhancing cardiorespiratory fitness and health, ensuring that the muscle mass would increase, improving the possibility of physical functioning, and reducing adiposity as part of improving on health outcomes.
Cardiovascular Disease and Exercise
One of the fundamental goals for patients suffering from rheumatoid arthritis, engaging in cardio training, is to help in reducing cardiovascular comorbidity with the sole intention being towards improving one’s quality of life. Cardio training is seen as being important in the overall process through which patients with rheumatoid arthritis seek to limit the impacts that they experience as a result of cardiovascular diseases. The fact that rheumatoid arthritis is common among women arises from the fact most of the women fail to understand the value that cardio fitness would have towards minimizing the risks that they encounter. Stavropoulos-Kalinoglou et al. (2009) argue that cardio training would help in reducing the risk of rheumatoid arthritis, especially among the women population, by a range of between 20% and 30%.
Cardio training would also serve as one of the key ways through which to ensure that patients with rheumatoid arthritis are able to improve on the general quality of life regardless of their challenges in terms of movement. The quality of life reduces as a result of a wide array of chronic conditions, which affect cardiovascular functionality. The ultimate result is that this creates a situation where most of these patients, regardless of the fact that they suffer from rheumatoid arthritis, spend much of their time seeking treatment. By engaging in cardio training, the patients would be in a better position of having to guarantee themselves the best possible prevention mechanisms touching on cardiovascular diseases (Greiwe, Cheng, Rubin, Yarasheski, & Semenkovich, 2001). That means that it becomes much easier for these patients to deal with the possibility of cardiovascular diseases that are likely to impact on their health.
Musculoskeletal Health and Exercise
Rheumatoid Cachexia and Skeletal Muscle Function
Approximately two thirds of patients diagnosed with rheumatoid arthritis suffer from cachexia, which is the significant wasting of the muscle mass within the body system. One of the key aspects to note is that the occurrence of rheumatoid cachexia creates a situation where patients with rheumatoid arthritis experience low skeletal muscle functionality. The ultimate result is that this is much more likely to expose the patients to significant challenges as part of their lives. In most cases, these patients also experience a significant loss of strength resulting from rheumatoid cachexia. Strasser, Leeb, Strehblow, Schobersberger, Haber, & Cauza (2011) take note of the fact that some of the patients with rheumatoid arthritis, who suffer from rheumatoid cachexia, find themselves losing approximately 70% of their muscle strength, which affects their overall functionality.
High intensity resistance training can help in reversing cachexia among patients with rheumatoid arthritis with the aim being towards improving their overall capacities to restore the overall muscle mass. Resistance training allows the patients to improve on their overall capacities to adopt effective use of their muscles as a way of ensuring that they not only achieve physical functionality but also reduces the possibility of disability (Hakkinen, Pakarinen, Hannonen, Kautiainen, Nyman, Kraemer, & Hakkinen, 2005). In most cases, patients with rheumatoid arthritis are expected to high intensity resistance training for a period of up to 24 weeks, which would aid towards improving their muscle strength and physical functionality. From that perspective, it can be argued that indeed the need for resistance training when dealing with patients suffering from rheumatoid arthritis is to enhance their overall capacities to reduce the risks of rheumatoid cachexia, as well as, working towards improving their skeletal muscle functioning.
Bone Mineral Density
Patients with rheumatoid arthritis experience a major challenge with regard to their bone mineral density, which reduces significantly causing overall possibility of bone loss, especially in the peripherals (de Jong et al., 2003). Low bone mass density creates a situation where most of the patients experience major challenges in terms of mobility considering that their bone density is not in any position to accommodate their weight. Additionally, this also arises from the fact that most of the patients find themselves experiencing major challenges in maintain their physical activities. Most of these patients often experience a loss in their hand grips and quadriceps, which are some of the key aspects to consider when evaluating the overall possibility of reduction in physical functionality. The ultimate result of this is that it paves the way for the overall need for patients to go through training as a way of improving their health outcomes.
Resistance training, specifically the use of load-bearing training, is considered as one of the most effective training approaches that would aid in the overall process of improving a patient’s bone mineral density (RA-A, 2003). During the resistance training, trainers are expected to come up with a structured approach that would allow them to maintain sufficient stimulus focusing on the weight loading process. That means that the trainers must be able to quantify the exact expectations relating to the bone mineral density depending on the weights that the patients are expected to use as part of their resistance training process. The ultimate result of resistance training is that it will help pave the way for an easier avenue through which patients with rheumatoid arthritis would be able to improve on their bone mineral density. That would pave the way for improved possibilities of regaining physical functionality.
Joint Health and Exercise
As has been noted earlier in this paper, patients suffering from rheumatoid arthritis tend to experience chronic joint inflammation, which affects their physical functionality significantly. The issue arises from the fact that these patients experience a significant loss in the stiffness within the tendon and loss of strength within the connective tissues. The ultimate result of this is that it creates a situation where it becomes difficult for the patients to maintain expected levels of physical functionality, as they often find themselves experiencing immense pain. That serves as a clear indication of the fact that it would be important to come up with a management mechanism that would aid in promoting joint health.
Engagement in resistance training is considered as one of key approaches that would aid in the overall process of increasing tendon stiffness while enhancing capacity to strengthen the connective tissue. In such cases, it becomes evident that indeed patients with rheumatoid arthritis are expected to adopt a structured approach that would allow them to advance overall effectiveness in maximizing on their strength. These patients are expected to embark on cyclic loading exercises, which include cycling, walking, jogging, and running among others (Baillet, Vaillant, Guinot, Juvin, & Gaudin, 2011). The cyclic loading exercises allow for an enhanced cartilage integrity while ensuring that the joints remain lubricated to help in reducing the possibility of pain during the course of movement. The main expectations associated with the resistance training process is that it will pave the way for an increase in range of motion, as it becomes much easier for the patients to improve on their physical functionality.
Improving Overall Function
Some of the key challenges that patients with rheumatoid arthritis encounter include disability, stiffness within the joints, fatigue, and severe pain during the course of movement, all of which tend to impair physical functionality. The need for having to engage in both cardio and resistant training is to allow for an easier control of the outcomes, as have been identified, while ensuring that the patients are able to maximize on their overall health outcomes. Both cardio and resistance training may play a critical role towards ensuring that the patients are able to deal with these impacts, as have been identified. The main expectation is that through training, patients would be in a better position allowing them to improve on muscle mass and strength to aid in purposes of improving physical functionality.
On the other hand, it must also be noted that the overall engagement in exercise allows for patients to ensure that their joints are able to conform to the general movements, which is important in reducing pain. Through exercises, patients find it much easier in their bid to ensuring that they are able to improve on their overall capacity to function effectively. Stiffness within the joints often occurs in the morning among patients with rheumatoid arthritis. The occurrence of such instances of stiffness tend to reduce significantly after patients have gone through a wide array of cardio and resistance training programs (Nurmohamed, Heslinga, & Kitas, 2015). The overall result is that the patients tend to find it much easier in their bid to improving on their overall health outcomes in a significant manner.
Perceptions of Rheumatoid Arthritis Patients on Cardio and Resistance Training
Regardless of the fundamental benefits that have been noted in the previous section, it must be noted that the population of patients suffering from rheumatoid arthritis is viewed as being less active when compared to the general population. The perception among patients with rheumatoid arthritis with regard to the overall possibilities of engaging in physical activities or training provides a clear understanding of what to expect. According to Agca et al. (2017), the three main barriers that affect the perception among these patients is fatigue, discomfort, and lack of motivation. That means that most of the patients suffering from rheumatoid arthritis find themselves in situations where they experience a significant reduction in the demand or urge for them to engage in any form of exercise. That creates the need for having to evaluate these barriers individually to determine their impacts on perception.
Fatigue
Patients with rheumatoid arthritis often experience high levels of fatigue considering that they experience a significant reduction in their muscle mass. A significant number of persons with rheumatoid arthritis argue that they often feel tired, which affects their motivation or capacity to engage in training. The occurrence of rheumatoid cachexia creates a situation where the patients’ muscle mass reduces at a significant rate while considering the overall possibility that most of the patients often find themselves lacking the expected strength levels. That creates a situation where it becomes hard for these patients to not only engage in exercises or training but also move around effectively. The challenge in dealing with fatigue is that the patients would be expected to develop the mental perception that would highlight the benefits associated with both cardio and resistance training.
From a psychological perspective, it can be argued that fatigue often creates a lack of enjoyment with regard to the nature of activities that the patients are expected to undertake as part of the training process. That creates some form of negative perception towards the need and value of both cardio and resistance training while considering the fact that it becomes hard for these patients to engage in the expected activities. However, it must be noted that receiving assistance during the course of training and exercising would serve as one of the ways through which to ensure that the patients with rheumatoid arthritis are able to build on their capacities. The ultimate result is that this would allow them achieve high levels of success in both cardio and resistance training.
Discomfort
Discomfort often occurs within the joints considering that rheumatoid arthritis is a condition that causes inflammation within the joints, which is likely to result in pain when a patient intends to engage in physical activities. The occurrence of rheumatoid arthritis creates a situation where patients are much more likely to experience high levels of pain within the joints considering that their joints are not well lubricated. That acts as one of the key barriers for most of the patients in their bid to engaging in both cardio and resistance training, as it becomes hard or challenging for some of these patients to actually be in a position to withstand the pain. Often, patients with rheumatoid arthritis take up to 2 training sessions after which a significant number drops out from the perception that they cannot be able to achieve the expected results as a result of the pain.
The perception created among patients with regard to the overall possibility of discomfort resulting from the pain that the patients experience revolves around the fact that it becomes hard for these patients to shut out the pain. That means that although most of the patients may opt to go ahead with the cardio and resistance training, it is important to take note of the possibility that they would experience high levels of pain. Trainers have a key role to play in their bid to providing assistance to the patients during the overall process of training, which would serve as one of the ways through which to define overall possibilities of success in the extensive use of these training approaches to deal with rheumatoid arthritis.
Lack of Motivation
Close family and friends play a critical role towards providing patients suffering from rheumatoid arthritis with the motivation that they would want in their bid to engaging in both cardio and resistance training. As has been noted from the first two factors, engagement in the training programs remains as one of the key challenges that the patients are likely to encounter in their overall processes of improving on their health outcomes. The challenge is that most of these patients find themselves in a situation where they are expected to engage in training regardless of the fact that they have limited physical functionality. Ultimately, this paves the way for the overall demand for motivation, which would act as one of the fundamental factors that would help towards changing the perception that these patients hold.
In cases where the patients do not have the motivation that they would want to engage in cardio and resistance training, the most likely outcome is that the patients would avoid such training while contending with other management and treatment mechanisms. The issue of motivation should only be viewed from the perspective of close families and friends but must also be viewed from the fact that trainers have a key responsibility in highlighting some of the underlying benefits that patients are likely to achieve in their extensive engagement in cardio and resistance training. The result is that this enhance the need for more of these patients to engage in cardio and resistance training with the sole intention being towards maximizing on the overall process of treatment and management of the rheumatoid arthritis.
Exercise Prescriptions for Rheumatoid Arthritis
From the discussions, it is clear that both cardio and resistance training are important in the management of rheumatoid arthritis. The following is an analysis of the prescriptions for each of these training approaches with the aim being towards ensuring that patients are able to achieve the best possible outcomes.
Cardio Training
Cardio training is viewed as one of the most basic forms of training, as it includes activities such as walking, jogging, running, aerobic dancing, and exercising in aquatic environments. Patients with rheumatoid arthritis are expected to take at least 1 hour every day to engage in any of these exercises, which would help improve on their capacities to reduce the possibility of cardiovascular diseases. The patients may interchange the exercises in a bid to ensuring that he or she is able to achieve the best possible outcomes.
Resistance Training
In resistance training, patients with rheumatoid arthritis are expected to like up with trainers with a high level of understanding of this type of training, as it involves performing a wide array of exercises aimed at elicit muscle hypertrophy and strengthening (Pedersen, 2017). In this type of training, one of the key aspects to note is that the trainers would be able to define the best possible program that would match expectation for the patients. In some cases, the patients would be expected to go through a training program that would aid in reducing fat mass while strengthening their muscle mass. Generally, it is important for the trainers to work in collaboration with the patients in a bid to ensuring that the training programs that they put in place are much more likely to achieve expected results.
Combination of Cardio and Resistance Training
For optimum results, some of the patients tend to focus on combining both cardio and resistance training with the aim being towards ensuring that the patients is able to improve on his or her cardiovascular health while strengthening his or her muscle mass. The adoption of the combined approach would mean that patients would be expected to engage in both cardio training, as have been prescribed, and resistance training, as will be prescribed by a trainer. In most cases, this would mean that the patients would spend up to 2 hours every day engaging in the two types of training programs. Additionally, this would also mean that the patients would expect high levels of assistance in the overall training approaches while considering the possibility that each of these training approaches would have its own set of challenges affecting the patients’ motivation.
General Exercise Guidelines
From a general perspective, it is important to take note of the fact that indeed training and exercising are key towards improving on the health outcomes for individual patients. In most cases, patients with rheumatoid arthritis find themselves in situations where they experience high levels of supervision in a bid to improving on their health while maximizing on the general expectations to achieve positive health outcomes. The patients ought to understand that although they are likely to encounter a wide array of challenges touching on their engagement in exercising, the possibility of success in minimizing the impacts of rheumatoid arthritis is high. Ultimately, this means that patients may need to develop a positive perception towards the training programs that they engage in as a way of ensuring that they improve on their capacities to achieve positive results.
Conclusion
In summary, rheumatoid arthritis (RA) is a chronic and systemic condition that occurs in form of chronic joint inflammation, which is characterized by serious limitations among patients in terms of movement due to pain and fatigue. A significant number of the patients suffering from rheumatoid arthritis experience an accelerated loss of muscle mass, which is a condition that is known as rheumatoid cachexia . One of the fundamental goals for patients suffering from rheumatoid arthritis, engaging in cardio training, is to help in reducing cardiovascular comorbidity with the sole intention being towards improving one’s quality of life. By engaging in cardio training, the patients would be in a better position of having to guarantee themselves the best possible prevention mechanisms touching on cardiovascular diseases. High intensity resistance training can help in reversing cachexia among patients with rheumatoid arthritis with the aim being towards improving their overall capacities to restore the overall muscle mass.
Resistance training, specifically the use of load-bearing training, is considered as one of the most effective training approaches that would aid in the overall process of improving a patient’s bone mineral density. Engagement in resistance training is considered as one of key approaches that would aid in the overall process of increasing tendon stiffness while enhancing capacity to strengthen the connective tissue. Through exercises, patients find it much easier in their bid to ensuring that they are able to improve on their overall capacity to function effectively. The three main barriers that affect the perception among these patients is fatigue, discomfort, and lack of motivation. Cardio training is viewed as one of the most basic forms of training, as it includes activities such as walking, jogging, running, aerobic dancing, and exercising in aquatic environments. In resistance training, patients with rheumatoid arthritis are expected to like up with trainers with a high level of understanding of this type of training.
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