By: Amelia Clark Arthritis Definition Epidemiology Symptoms - PowerPoint Presentation

By: Amelia Clark Arthritis

Definition Epidemiology SymptomsDiagnosisTreatmentEffects of ExerciseExercise TestingExercise RxSummary/References Overview

Definition No cure YouTube - osteoarthritis

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) Definition Types of Arthritis Normal wear & tear of aging Heredity, obesity, injury Commonly affects: hands, spine, hips, knees

Rheumatoid (RA): inflammation of synovial membrane, formation of pannus tissue, & eventual deterioration of bone and cartilage. Autoimmune diseaseOther:Juvenile arthritisAnkylosing SpondylitisLupusfibromyalgia Psoriatic arthritisGoutPseudogout DefinitionTypes of Arthritis Commonly affects: Wrists, hands, knees, feet, cervical spine

UNITED STATES 1 in 5 adults=46 million More common among women1 in 250,000 children has arthritis (294,000)Most common cause of disabilityMore than back problemsUTAHAdults with arthritis: 399,000 Have arthritis & are overweight/obese: 71%Have arthritis & are physically inactive: 14% Epidemiology

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.

Symptoms Swelling PainStiffnessLimited movementFatigueRedness around joint AgeGeneticsOverweight/obesity FemalesSmokersPrevious injuryOccupation w/ repetitive movements Symptoms & Risk Factors Risk Factors

Diagnosis Medical HistoryPhysical Exam Lab Tests

Diagnosis Medical History Information about your health background Heredity Description of symptoms you’ve been havingDetails about how and when symptoms beganWhere?How is it affecting you?Other medical problems?

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 jointsROMGoniometerExamine position & alignment of neck and spine.Watch you walk to see how you are able to move hips and knees. Diagnosis Physical Exam

Osteoarthritis Joint aspiration extracts fluid for evidence of crystals or joint deteriorationX-raysee damage to boneMRIsee soft tissue and cartilage NEW!MRI measures GAGs & early detection Sed rateRate at which blood cells sinkC-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 scansDetect inflammationMRI Synovitis, inflammation in other organs DiagnosisLab Tests Rheumatoid Arthritis

Medications Nonpharmacologic Therapies Surgery Treatment

Treatment Medications NSAIDsTarget pain and inflammationCan be hard on the stomach and GI tract AcetaminophenPain onlyTopical pain relievers Pain onlyCorticosteroidsRelieve inflammation quicklyGood for RADon’t use frequently Disease-modifying antirheumatic drugs (DMARDs)

Treatment Nonpharmacologic Therapies HypnosisAromatherapySupplementsFish oilPhysical Therapy Electrical StimulationExercise Weight lossPatient 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

Joint replacement Improved movement Pain reliefImproved joint alignmentArthroscopic surgeryNot very beneficial for arthritis Youtube -Fight arthritis pain Treatment Surgery

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

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

Submaximal tests Treadmill (<3mph)Cycle ergometerSuspected cardiopulmonary disease-do a different test1 rep max Low intensity intiallyROM ( goniometery)Gait analysis- for those with severe diseaseAvoid morning exercise (especially with RA)Spinal involvement may cause nerve disfunction Avoid vigorous and high repetitive exercises with unstable joints Exercise Testing

Methods Suggested Tests StrengthRepetition Max (1, 8, or 12)Endurance 6 min walkAerobic capacity (REP 6-20)Flexibility (helpful in preventing injury) Goniometry (ROM, symmetry) Functional Balance tests, gait analysis Exercise Testing Recommendations

Goniometry Testing Tests Range of Motion (ROM) P rogression of disease Lack of progression of therapy

Norms Joint Flexion ExtensionHip 115-125°10-30°Knee 135-150° 0 - -10° Ankle 0-10° (dorsiflexion) 20-30° (plantarflexion) Shoulder 160-180°40-60°

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 routineAvoid activities that increase joint painPost-exercise soft tissue discomfort is expected Exercise PrescriptionRecommendations

Do’s Low-impact Muscle are strengthened before increase in intensityflexibility/ROMProper shoesSeveral short sessions if necessaryAlternate exercise modes Time goals (not distant) Stop and go movementsProlonged one –legged stanceStair climbingContact sports Overstretching & hypermobility If pain or swelling-reduce load on joint Don’t encourage client to exceeding guidelines Exercise Prescription Recommendations Don’ts

Modes Intensity FrequencyDuration Aerobic 40-60% VO2max3-5 days/week 5-10 min build to 30 min sessions Strength 1 or more sets of 2-3 reps, building to 10 reps 2-3 days/week ------ Flexibility Before aerobic or strength activities Exercise Prescription ACSM guidelines

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 Summary

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-wFQhttp://en.allexperts.com/q/Etymology-Meaning-Words-1474/arthritis.htmJanssen, 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