THE OFFICIAL NEWS SOURCE OF ACR CONVERGENCE 2022 • NOVEMBER 10-14



Exercise: A prescription everyone needs to fill

This year’s ARHP Keynote Address focused on the one prescription available to everybody that has unlimited refills — physical activity.


“I tell my patients that if I could pick one medicine in the world, I’d pick 30 minutes of walking a day,” said Alex M. McDonald, MD, CAQSM, during Exercise Is Medicine: We All Need to Say the SameThing.


Teresa J. Brady, PhD, Senior Behavioral Scientist with the Arthritis Program at the Centers for Disease Control and Prevention, said that a new study found that 41.2 percent of people with arthritis fell into the inactive aerobic group (engaged in no moderate-intensity equivalent leisure-time activities that lasted at least 10 minutes) as defined by U.S. Health and Human Services. 


“We’ve got plenty of room to grow to help people get more active,” Dr. Brady said, and even if those with arthritis can’t meet the federal guidelines, some activity and at least making sure people get off the couch provides the “biggest bang for the buck.”


Those with arthritis face many of the same barriers to exercise as those who don’t have arthritis, she said, and face additional obstacles: pain and fear of making pain worse, uncertainty about what and how much to do, not having easy access to arthritis-specific programs, and having physicians not mention or emphasize physical activity. 


A study comparing exercisers to non-exercisers found that the exercisers reported more barriers than non-exercisers but were better problem-solvers.


“They figured out ways around the barriers, where the non-exercisers were defeated by the barriers and stopped altogether,” she said. “I think that highlights the importance of teaching problem-solving skills, as well.”


Dr. McDonald said that healthcare professionals in some cases need to give patients permission to move while acknowledging those barriers.


“You need to be their partner,” he said. “Show them that it’s OK to exercise.”


Dr. McDonald, a sports medicine physician and former professional triathlete, emphasized that those working with patients need to set a good example by being physically active themselves. 


No patient should leave an office visit without an assessment of current physical activity, counseling and reassurance about exercise, a prescription for exercise, referral to fitness professionals, and motivation. 


For patients just starting physical activity, Dr. McDonald recommends starting with flexibility and range-of-motion exercises such as gentle stretching and yoga. He then introduces aerobic activity, followed by strength training and eventually balance training. No matter the order, he said, start low and go slow, just like starting a new drug, and help patients establish a routine and find something they enjoy.