Physical activity recommendations for patients with OA and inflammatory arthritis published
medwireNews: EULAR has issued evidence-based recommendations for physical activity in patients with osteoarthritis (OA) and inflammatory arthritis.
“There is strong evidence for the benefits of [physical activity] on improvements [in] disease activity, activities and participation,” but people with rheumatic diseases “are in general less active compared with healthy controls,” say the guideline authors, led by Karin Niedermann (University of Applied Sciences, Winterthur, Switzerland), in the Annals of the Rheumatic Diseases.
They suggest that possible reasons for this could include patients and healthcare providers fearing flares or joint damage as a result of exercise, or a lack of specific information about the required type and amount of physical activity in current guidelines for the management of these conditions.
The EULAR taskforce of 22 experts from 16 European countries – comprising rheumatologists, other medical specialists, patient representatives, health professionals, and methodologists – developed four overarching principles and 10 recommendations for physical activity for patients with OA, rheumatoid arthritis, and spondyloarthritis on the basis of a systematic literature review and expert opinion.
In their overarching principles, Niedermann and colleagues say that physical activity has a role in optimizing health-related quality of life, and is beneficial for patients with OA or inflammatory arthritis. They emphasize that physical activity recommendations for the general population also apply to patients with these conditions, but that discussions between healthcare providers and patients are needed, taking into account people’s capabilities, preferences, and resources.
The specific recommendations advocate that, in light of the evidence for its effectiveness, feasibility, and safety, physical activity “should be an integral part of standard care” for people with OA or inflammatory arthritis.
Niedermann and co-authors stress that all healthcare providers have a responsibility to promote physical activity for these patients, and interventions to promote activity should have clear personalized aims, include behavioral change techniques, and be delivered by trained professionals.
Although the guideline authors found “no evidence on the necessity of general adaptations” to physical activity in people with OA or inflammatory arthritis, they acknowledge that adaptations may be required, and “should be made on a comprehensive individual assessment.” They also recommend that healthcare providers “should consider the whole range of modes to deliver interventions,” as no evidence for the superiority of any particular delivery method was found.
The recommendations also include a proposed future research agenda based on current gaps in knowledge, including evaluating the impact of reducing sedentary behavior, assessing the long-term impact of physical activity at different intensities, and identifying disease-specific contraindications for certain types of activity.
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