Fitness

Getting active Most of us know that light exercise can make a difference to our fitness and mobility levels, but is it still possible when you have arthritis? Words: StepHen Grinnell e xercising to help with self-management of chronic conditions such as osteoarthritis is nothing new. In fact, its recommended by both the NHS and the National Institute for Health and Care Excellence (NICE). The problem is, the exercise recommended is moderate to intense physical activity for 30 minutes, five times a week, with a focus on walking. The guidelines are the same for everyone, because its said to be the optimal amount needed for long-term health benefits. This presents a problem for people with arthritis, however, because they tend to have reduced mobility and pain while exercising for extended periods particularly when doing weight-bearing activities. In a recent study I conducted, a 20per cent reduction in pain and a 30 per cent increase in mobility was achieved by participants with osteoarthritis after six weeks of exercise. The programme consisted of four short sessions per week, with a longer class-based session each week. lower-body strength A series of static exercises, using a chair for support, was devised, with the focus on building up initial strength, predominately in the lower body. This allowed participants to improve strength, coordination, balance and most importantly confidence. The walking element was initially just 40m (four x 10m with a turn), but the emphasis was on speed. This wasto improve the quality of movement and make it a conscious focus for people to improve their balance and coordination. All of the participants were asked to analyse which elements of the exercise they found difficult, and why. Each person was supported to help with increasing their range of movement, balance and coordination, and this improved their confidence. For the study, the target was to walk continuously for just six minutes. People practised walking and recorded the distance covered over the six weeks (breaks were allowed if required). The average increase in distance in six minutes was 100m a 25 per cent increase. Over the 40m distance with turns, the participants improved by 12 per cent. The strength exercises allowed participants not only to make physical improvements, but also build up confidence that they could do exercise. Physical strength improved by 38 per cent during the study, with a massive increase in confidence to perform normal, everyday movements. Initial testing for strength and walking put half of the participants in the study at risk of falls, but by the end of the study all participants were above the falls threshold for walking, and above strength levels for able-bodied people with no arthritis. The study was conducted as part of a GP exercise-referral scheme in a community setting. The results show that even with arthritis it is still possible to reduce pain and improve mobility. n Stephen Grinnell MSc Health, Rehabilitation and Exercise, is a GP referral exercise instructor and coordinator If you donT fInd exerCIse easy not everyone will be able to do these exercises, especially if youre in a lot of pain. speak to your gp about simple ways to get active, such as increasing the time you walk each day, or simple stretches that you can do from a chair at home. download our free booklet on exerciseat www.arthritiscare.org. uk/exercise or call free on 0808 800 4050. or order a copy of our chair-based exercise dVd at www. arthritiscare.org.uk/dVd (7 plus 1.50 p&p). ITs your Turn Try six minutes of walking with a focus on speed twice a week and complete the exercises below, if you feel able, four times a week to see similar results.* Do one set of each exercise and work through the circuit, then repeat three times #1 Chair squats #4 Wide chair squats Holding the back of a chair, with your feet in line with your shoulders, slowly squat as low as you can and then come back to standing. do: three sets of 12 repetitions Place a chair in front of you and hold the back of it, keeping your feet wider than yourshoulders. Squat slowly as low as you can and then come back to standing. do: three sets of 12 repetitions #2 Alternate knee raise Holding the back of a chair, with your feet placed wider than your shoulders, raise one knee to your chest, then return. Repeat with the other knee. do: three sets of 12 repetitions each leg #3 Supported lunges Hold the back of a chair with your right hand and face to the left. Step forward with your left leg and bend into the knee. Repeat on the other side, holding the chair with your left hand, facing to the right. do: three sets of 12 repetitions each leg #5 Step-back lunges Place a chair in front of you and hold the back of it, keeping your feet in line with your shoulders. Step back with your right leg and bend your left leg to support; repeat with the opposite leg step back with your left and bend your right to support. do: three sets of 12 repetitions on each leg to continue benefiting from the increasing mobility and reduction in pain, the exercises and physical activity need to be performed regularly. *always check with your gp before starting any exerciseprogramme