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High-intensity interval walk training associated with decreased disease activity in rheumatoid arthritis

A recent study has shown exciting new benefits associated with exercise for people living with rheumatoid arthritis (RA).

image of someone on a treadmill

Rheumatoid arthritis is an autoimmune disease with hallmark symptoms of inflammation and resulting pain. It is a disease process (like cancer or diabetes) where the body’s immune system mistakenly attacks its own healthy joints. It is a relatively common disease – approximately 300,000 or 1 in 100 Canadians get it – and is often devastating to a person’s body if not treated properly.

Researchers at Duke University in North Carolina found that 10 weeks of high-intensity interval walk training was associated with decreased disease activity and improved immune function for adults with RA. High-intensity interval walk training refers to a popular form of exercise that includes short bursts of fast-paced walking at maximum effort followed by less intense recovery periods.

The study included twelve physically inactive adults over the age of 55, with a confirmed diagnosis of RA. Participants completed a 10-week program consisting of 3x 30-minute sessions a week of supervised treadmill walking. This Included a 5-minute warm up and 5-minute cool down. Within the training session, participants walked at 80-90% of their maximum effort in intervals of 60 to 90 seconds. These high-intensity intervals were followed by recovery intervals at 50-60% maximum effort. Speed and interval times varied for each person based on a cardiorespitory fitness test, but none exceeded walking pace. 

Disease activity was assessed by a rheumatologist through a count of swollen and tender joints, perceived general health and blood tests to measure inflammation. Cardiovascular fitness and immune functions were assessed using a variety of clinical and laboratory tests, as well as standardized questionnaires. At the end of the 10 weeks, the following outcomes were observed:

  • RA disease activity reduced by 38%, with a significant decrease in swollen joints, erythrocyte sedimentation rate (ESR) and improved self-perceived health. An ESR blood test measures the rate at which red blood cells settle in the period of one hour, revealing inflammatory activity in the body. 
  • Improved immune functions suggesting a reduced infection risk and inflammatory potential 
  • Cardiorespitory fitness increased by 9%
  • Resting blood pressure and heart rate both reduced 

 There is a substantial amount of research on exercise and rheumatoid arthritis, but few studies have reported the actual lowering of disease activity scores. As stated by the researchers, this study suggests that,

“High intensity interval walking could be an efficient, tolerable, and highly effective intervention to augment disease activity and improve overall health in patients with RA.”

There are certain limitations to the study such as the small sample size and no control group, but the findings will hopefully encourage more research in the area. In addition, these findings add to a growing body of research on the benefits of exercise for people with arthritis. To learn more about the study, click here.


To learn more about physical activity and arthritis visit the following pages:

A short 10-minute walk can benefit the brain

A recent study published in Proceedings of the National Academy of Sciences determined that even ten minutes of mild exercise can benefit the brain. In the study, scientists from the University of California, Irvine, and the University of Tsukuba in Japan looked at a group of healthy young college students.

The study had 36 participants. They visited the research lab two separate times. On the first visit, each participant sat on a stationary bicycle for 10 minutes. On the second visit, they pedalled the bicycle at a gentle pace that barely increased their heart rates.

New York Times summarized: “In technical terms, the exercise was performed at about 30 percent of each volunteer’s heart rate reserve, or the difference between a person’s maximum heart rate and their resting heart rate. By comparison, brisk walking should raise someone’s heart rate reserve to about 50 percent.”

Participants completed a computerized memory test immediately after each session of sitting or slow pedalling. In the test, the participants would see a brief picture of an object (such as a tree), followed by a variety of other images and then a new image of either the same object or a similar object. Participants had to press buttons to indicate whether they thought each image was new or the same as an earlier image. Images closely resembled one another. The same process was repeated, with testing being completed inside an M.R.I machine that scanned the participant’s brains while they responded to the images.

Results showed that even though the exercise was undemanding, it had an effect on brain function. Participants were better at remembering images after they had ridden the bicycle, especially when the images closely resembled one another. Researchers also found that exercise altered how certain parts of the brain communicate and coordinate with one another. Exercise also improved memory function. The findings suggest that exercise does not need to be long and rigorous to benefit the brain. The effects can take place far more quickly than many of us might expect.

In an interview with New York Times, Michael Yassa, the director of the U.C. Irvine Center for the Neurobiology of Learning and Memory and senior co-author of the new study with Hideaki Soya of the University of Tsukuba, concluded: “It was exciting to see those effects occurring so quickly and after such light exercise. The findings show that exercise can change people’s brains and minds right away without requiring weeks of working out. Even better, the exertion required can be so slight as to allow almost anyone, even those who are out of shape or possibly disabled, to complete the exercise.”

More research needs to be completed to determine how, at a molecular level, gentle exercise affects brain function. Click here to learn more about the study.

Yoga and Arthritis

Person doing a yoga poseThe most recent EULAR recommendations for pain management in inflammatory arthritis and osteoarthritis (OA) include physical activity and exercise as a part of a patient’s treatment plan. Physical activity has been shown to significantly ease joint pain and increase mobility, for this reason, exercise is increasingly being prescribed by physicians and other healthcare providers.

Some examples of well-known and effective exercises for people with arthritis include walking, biking and swimming. These are low-impact aerobic exercises, meaning they will generally be easier on the joints and cause your heart rate to increase. Are there other activities that could also benefit people living with arthritis, such as yoga?

Yoga is a group of physical, mental, and spiritual practices which originated in ancient India. Yoga increases flexibility, balance and muscle strength, improves fitness, and relieves pain. A recent study conducted by a team of researchers in China found that if practiced regularly, yoga can effectively alleviate pain and improve joint function for people with knee arthritis. According to the researchers, whole body benefits involve “reducing stress, lowering blood pressure, and metabolic regulation.” A healthy metabolic regulation affects how your body absorbs the nutrients it is getting.

The specific research method used in this study was a meta-analysis. Researchers looked at previous studies where yoga was used as an intervention to treat knee arthritis, and then analyzed the results of all of these studies to determine the efficacy of the activity. In total, 13 clinical trials with 1,557 patients with either knee osteoarthritis or rheumatoid arthritis were analyzed, with a specific focus on how yoga impacts pain reduction, joint function, and general wellbeing. This research method provides a more wholistic picture on the impacts of yoga on arthritis outcomes than a single study would.

Researchers concluded that if yoga is practised regularly, it is helpful in reducing symptoms, promoting physical function, and general wellbeing for patients with knee arthritisThey added: “This review indicates that yoga intervention could be used for relieving OA pain; however, in the absence of high-quality studies with low risk of bias, the true benefits of yoga, although promising, are still undetermined.”

Researchers believe that there are two reasons why yoga can help reduce pain in patients with knee arthritis:

  • Yoga increases joint stability by strengthening muscles and therefore, reduces physical pain. Strengthening the knee muscles to support your body weight is a primary goal in an arthritis treatment plan.
  • Yoga promotes proper body positioning and helps reduce stress. The stress reducing component is effective in pain management for patients with knee arthritis.

In addition, people who practiced yoga also experienced an increased awareness of their mental health. They were found to be more accepting of their condition and more detached from the psychological experience of pain.

While more research is still needed, yoga is a fun form of physical activity that can be practiced anywhere, either alone or with others, making improving arthritis outcomes even more convenient. To learn more about exercise and arthritis, listen to this JointHealth™podcast featuring physiotherapist and researcher Linda Li, from Arthritis Research Canada.