One cannot go anywhere without hearing the many health benefits of daily physical activity and regular exercise programs. Add another benefit to the mix -- Dr. Ronenn Roubenoff (Tufts University, Boston, MA) says there is a growing body of literature demonstrating that exercise can reverse many of the effects of chronic inflammation on muscle. This is of particular importance for people with ankylosing spondylitis (AS) and its related diseases, who are more prone to develop fusion (the formation of extra bone in the body) as a result of the inflammatory nature of the disease.

According to Roubenoff, the major barrier physicians in the medical community and the public at large to understand the importance of exercise. Rheumatoid cachexia is one of the effects of chronic inflammation on the body, which leads to loss of lean body mass. Any form of exercise will help counteract this problem.

During and before the 1970's, physicians tended to recommend rest and a reduced level of physical activity for patients with arthritis. Challenges to this notion occurred during the 1980's, and during the 1990's there was growing recognition that almost any form of exercise provides much more benefits for arthritic patients than does inactivity.

"A combined approach using both strength training and aerobic exercise is likely to be optimal, and can be accomplished by most persons in less than one hour a day," suggests Roubenoff. Aerobic exercises, like swimming and walking,

"Cachexia can occur in the presence of adequate dietary intake and appears to be driven primarily by inflammation-mediated changes in metabolism," explains Roubenoff. To date, all attempts to reverse rheumatoid cachexia with drugs have failed. In contrast, Roubenoff notes how many studies suggest that exercise can be used safely to provide the needed anabolic signal to muscle

Roubenoff wants the American College of Rheumatology, the professional organization of rheumatologists and associated health professionals, to consider a position statement on exercise. "Such a statement would need to emphasize the importance of strength training and aerobic exercise -- as distinct from symptom-directed physical therapy -- as a routine part of care of all patients with inflammatory diseases."

A recent study showed that the prevalence of physical activity among patients with rheumatoid arthritis is higher than that found among those without arthritis. Less than one quarter of arthritic study participants reported meeting physical activity among recommendations. Among arthritis patients, the prevalence of inactivity was highest among women (33.6%), people over the age of 45, blacks (37.7%), Hispanics (42.5%), the obese (35.7%), and people with 12 or less years of education (36.7%). A large survey of the U.S. population (2000 Behavorial Risk Factor Surveillance System) found that 30.8% of people without arthritis were inactive, compared to 25.8% of people without arthritis. The study authors stress the importance of promoting increased physical activity among people with arthritis.

Results were published in a recent issue of Arthritis Care & Research.