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Exercise and Rheumatic Diseases
improving through moving
Jennifer Horonjeff, MS, PhD CandidateErgonomic Consultant, Certified Pilates Instructor
[email protected] of Ergonomics and Biomechanics
Occupational & Industrial Orthopaedic CenterNew York University
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Some Considerations
What are your complaints about the disease?
What are your excuses for not to exercising?
Do you feel comfortable talking about exercise with your doctor?
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A little bit of history….
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Bone
Responds to physical demand
Bone mineral density improves with exercise
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Cartilage
Cyclical loading shown to have anti-inflammatory properties and may dampen cartilage destruction
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Muscle
Rheumatic diseases affect muscles too!
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Motor Control
• Reaction Time
• Muscle activation strategies
• Proprioception
• Balance
THE BODY CAN REWIRE!
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People with inflammatory arthritis and fibromyalgia who exercise regularly, complain of less pain and fatigue!
Pain and Fatigue
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Inactivity Cycle
Lack of Physical Activity
•Deconditioning of muscles•Increase weight•Activities require greater effort•Increase chance for injury•Increase in pain
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Physical Activity Recommendations
Centers for Disease Control and Prevention and American College of Sports Medicine
Accumulate at least 30 minutes of moderate intensity physical activity on most, if not all days of the week.
30 MIN DOES NOT NEED TO BE CONSECUTIVE!
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Start slow
Listen to your body
Find range where you feel good without over-doing it and you’ll be
more likely to stick with it!
No one program is right for everyone
Is it safe?
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Types of Exercise
Strength-conditioningAlone not able to bolster bone mineral density
Dynamic high-intensity exerciseReduction of disease activity greater than usual care
Non-weight bearing exercises Best when baseline radiologic damage exists
HydrotherapySome people have experienced feeling better than did with land
exercises
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Enjoy it!
MUST BE ENJOYABLE!
Fitness programs with social or self-efficacy component had greater compliance
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Goals
During a flare: PRESERVE!
When under control: Improve fitness and participation in activities
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Stretching
Aids in release of tightened muscle bands and provides pain relief
Stretch to point of resistance and hold stretch•Allows Golgi tendon to signal muscle fibers to relax
DO NOT stretch to point of increased pain—causes muscle fibers to contract and have opposite effect.
NO BOUNCING!
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Physical Benefits
•Weight loss
•Improve aerobic capacity
•Improve cardiovascular health
•Improve range-of-motion
•Reduction in pain
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Overall Benefits•Improve functional abilities
•Improve quality of life
•Improve sense of well-being
•Improve quality of sleep
•Increase energy
•Reduce anxiety and depression
•Stimulate endorphins
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What is your excuse not to exercise?
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“The design of work in relation to the capabilities of people”
People
ErgonomicsErgonomics
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Ergonomic Risk Factors
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Ergonomics InjuriesMusculoskeletal DisordersMusculoskeletal Disorders
• Acute Trauma Disorders (ATD’s)Acute Trauma Disorders (ATD’s)• Injuries which occur instantaneously due to
a known cause
• Cumulative Trauma Disorders (CTD’s)Cumulative Trauma Disorders (CTD’s)• Injuries occurring over time due to
repeated exposure to various risk factors
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Identify the Issues
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Copyright 2008 © United States Ergonomics
Normal and Maximum Working Area
Work Envelope and Work Envelope and ReachReach
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Keyboard & MouseThe Neutral Wrist Position = StraightThe Neutral Wrist Position = Straight
AVOID Wrist AVOID Wrist bending bending
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Hand Stress vs. posture
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Shoulder Posture vs. Shoulder Posture vs. Strength Strength
Shoulder Abduction
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Line of sight
April 13, 2023
• The viewing angle will determine the head/neck posture
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Neck Posture
Headset Preferred Not as Effective
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Forces on the Spine
Spine Stress
Vs.
Lifting Posture
Poor Good
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Pressure on spinal discs
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Be kind to your feet!
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So, get up…
…and get moving!