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Arthritis

Arthritis. By: Amelia Clark. Overview. Definition Epidemiology Symptoms Diagnosis Treatment Effects of Exercise Exercise Testing Exercise Rx Summary/References. Definition. No cure. YouTube - osteoarthritis. Definition Types of Arthritis. Over 100 types

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Arthritis

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  1. Arthritis By: Amelia Clark

  2. Overview • Definition • Epidemiology • Symptoms • Diagnosis • Treatment • Effects of Exercise • Exercise Testing • Exercise Rx • Summary/References

  3. Definition No cure YouTube - osteoarthritis

  4. DefinitionTypes of Arthritis • Over 100 types Osteoarthritis (OA): Deterioration or loss of cartilage in synovial joints, particularly in weight-bearing joints followed by formation of bone spurs and subchondral cysts. • Also known as Degenerative Joint Disease (DJD) Commonly affects: hands, spine, hips, knees Normal wear & tear of aging Heredity, obesity, injury

  5. DefinitionTypes of Arthritis • Rheumatoid (RA): inflammation of synovial membrane, formation of pannus tissue, & eventual deterioration of bone and cartilage. • Autoimmune disease • Other: • Juvenile arthritis • Ankylosing Spondylitis • Lupus • fibromyalgia • Psoriatic arthritis • Gout • Pseudogout Commonly affects: Wrists, hands, knees, feet, cervical spine

  6. Epidemiology • UNITED STATES • 1 in 5 adults=46 million • More common among women • 1 in 250,000 children has arthritis (294,000) • Most common cause of disability • More than back problems • UTAH • Adults with arthritis: 399,000 • Have arthritis & are overweight/obese: 71% • Have arthritis & are physically inactive: 14%

  7. Epidemiology Being overweight or obese increases your risk for arthritis. Arthritis is often coupled with diabetes and obesity. Physical activity can help prevent risk of arthritis.

  8. Symptoms & Risk Factors Symptoms Risk Factors • Swelling • Pain • Stiffness • Limited movement • Fatigue • Redness around joint • Age • Genetics • Overweight/obesity • Females • Smokers • Previous injury • Occupation w/ repetitive movements

  9. Diagnosis • Medical History • Physical Exam • Lab Tests

  10. DiagnosisMedical History • Information about your health background • Heredity • Description of symptoms you’ve been having • Details about how and when symptoms began • Where? • How is it affecting you? • Other medical problems?

  11. DiagnosisPhysical Exam • Looks at joints • Touches those described • Looks for areas that are tender, painful, or swollen, or indications that the joint is damaged. • May be asked to stand up and move joints • ROM • Goniometer • Examine position & alignment of neck and spine. • Watch you walk to see how you are able to move hips and knees.

  12. DiagnosisLab Tests Osteoarthritis Rheumatoid Arthritis • Joint aspiration • extracts fluid for evidence of crystals or joint deterioration • X-ray • see damage to bone • MRI • see soft tissue and cartilage • NEW! • MRI measures GAGs & early detection • Sed rate • Rate at which blood cells sink • C-reactive protein • Measure inflammation • Rheumatoid factor • Antibody found in blood • Antinuclear antibodies • Antibody combined with nuclei • Anti-CCP • Antibody • X-rays • Swelling of soft tissue, loss of bone density • Bone scans • Detect inflammation • MRI • Synovitis, inflammation in other organs

  13. Treatment Medications Nonpharmacologic Therapies Surgery

  14. TreatmentMedications • NSAIDs • Target pain and inflammation • Can be hard on the stomach and GI tract • Acetaminophen • Pain only • Topical pain relievers • Pain only • Corticosteroids • Relieve inflammation quickly • Good for RA • Don’t use frequently • Disease-modifying antirheumatic drugs (DMARDs)

  15. TreatmentNonpharmacologic Therapies • Hypnosis • Aromatherapy • Supplements • Fish oil • Physical Therapy • Electrical Stimulation • Exercise • Weight loss • Patient Education • Splints/assistive aids • Essential Oils • Rub on hands and put rubber gloves on and soak on warm water 5-10 minutes • Meditation • Reduced pain in 56% of participants • Hot & Cold treatments

  16. TreatmentSurgery • Joint replacement • Improved movement • Pain relief • Improved joint alignment • Arthroscopic surgery • Not very beneficial for arthritis Youtube-Fight arthritis pain

  17. Effects of Exerciseability to exercise • RA can affect cardiac and pulmonary function. Could cause vasculitis. • Fear of joint pain or harming joint • Joint ROM restriction • Inability to perform rapid repetitive movements • Deconditioned joints-swelling decreases performance • “out of shape” • Increased resting energy expenditure (REE) as much as 50%

  18. Effects of Exerciseability to exercise • Other diseases (i.e. diabetes, obesity, heart disease) • Improve cardiovascular status, balance, flexibility and general health • Decreased joint swelling • Improve: • Function • Mood • QOL • Mobility • Increased social and physical activity • Reduced depression and anxiety • Associated with… Every 1 lb lost is 4lbs off your knees!

  19. Exercise Testing • Submaximal tests • Treadmill (<3mph) • Cycle ergometer • Suspected cardiopulmonary disease-do a different test • 1 rep max • Low intensity intially • ROM (goniometery) • Gait analysis- for those with severe disease • Avoid morning exercise (especially with RA) • Spinal involvement may cause nerve disfunction • Avoid vigorous and high repetitive exercises with unstable joints

  20. Exercise TestingRecommendations

  21. Goniometry Testing Tests Range of Motion (ROM) Progression of disease Lack of progression of therapy

  22. Norms

  23. Exercise PrescriptionRecommendations • Stretching and warm-up always (even on days when there is a flare up) • Use weight-bearing, partial weight-bearing and non-weight-bearing exercises • Recommend learning a strength routine • Avoid activities that increase joint pain • Post-exercise soft tissue discomfort is expected

  24. Exercise PrescriptionRecommendations Do’s Don’ts • Low-impact • Muscle are strengthened before increase in intensity • flexibility/ROM • Proper shoes • Several short sessions if necessary • Alternate exercise modes • Time goals (not distant) • Stop and go movements • Prolonged one –legged stance • Stair climbing • Contact sports • Overstretching & hypermobility • If pain or swelling-reduce load on joint • Don’t encourage client to exceeding guidelines

  25. Exercise PrescriptionACSM guidelines

  26. Summary • Arthritis is characterized by swelling in the joint(s). • Osteoarthritis, rheumatoid arthritis are most common. • It is often common in people with other conditions such as heart disease, obesity, and diabetes. • Exercise helps decrease symptoms and is affective for and increase in QOL. • Exercise Rx should include a variety of modes of exercise and flexibility. • Low-impact exercises are best

  27. References Brittain, D.R., Gyurcsik, N.C., McElroy, M., Hillard, S.A. (2011). Woman’s Health Issues. (issue 1, vol. 21). www.youtube.com/watch?v=0dUSmaev5b0&feature=related www.youtube.com/watch?v=u8bV5eV-wFQ http://en.allexperts.com/q/Etymology-Meaning-Words-1474/arthritis.htm Janssen, I. I., & Mark, A. E. (2006). Separate and combined influence of body mass index and waist circumference on arthritis and knee osteoarthritis. International Journal of Obesity, 30(8), 1223-1228. doi:10.1038/sj.ijo.0803287 www.cdc.gov/arthritis/resources/quickstats.htm www.arthritistoday.org www.nejm.org/doi/full/10.1056/NEJMoa0708333 www.cdc.gov www.lhup.edu/yingram/jennifer/webpage/homepage2.htm

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