Patients with rheumatoid arthritis often present with symptoms of depression, anxiety, and fatigue. These symptoms may be exacerbated during the 2019 coronavirus disease (COVID-19) pandemic, during which the resulting fear and isolation have also contributed to feelings of depression and burnout.
Clinicians often recommend physical activity for patients with rheumatoid arthritis to help manage pain and pain, but it can also benefit their mental health and overall quality of life. What are some physical activities, exercises, or the like that doctors can recommend to their rheumatoid arthritis patients who may experience mental fatigue?
While some activities may be too strenuous for them, light physical activity at home may be more helpful than patients realize. A recent study published in International Rheumatology found a positive correlation between physical activity and psychological well-being in rheumatoid arthritis patients during the COVID-19 pandemic. A significant portion of the measured activity was referred to as “light physical activity” and included household chores such as laundry.
The researchers found that this light physical activity was positively associated with vitality and negatively associated with depressive symptoms and mental fatigue in participants. Small physical tasks like this correlate with lower levels of mental fatigue and can prevent patients who are in self-isolation from spending too much time being sedentary.
Walking was also strongly correlated with a decrease in physical fatigue and depressive symptoms. It offers the possibility of physical activity outdoors, which has been more difficult during the COVID-19 pandemic. Walking is an exercise that is not too strenuous and allows people to do it at their own pace.
Cycling is another outdoor activity that patients can enjoy during the COVID-19 pandemic. The researchers included cycling in the “exercise” category of the study, and exercise was associated with a more significant decrease in general fatigue than walking or light physical activity. Exercise was also correlated with a decrease in depressive symptoms and anxiety. As other exercises that clinicians recommend for rheumatoid arthritis patients become more difficult to do in the midst of the pandemic (eg, an aerobics class), cycling presents a more viable exercise option.
Yoga has often been cited as a potential addition to rheumatoid arthritis treatment that can help relieve symptoms. It’s also a versatile activity for rheumatoid arthritis patients, with routines and poses that can be adjusted to suit individual needs. Online yoga classes also provide an opportunity for individuals to connect with others, which can also help alleviate the feelings of isolation felt by many people during the COVID-19 pandemic.
Stretching should be done before and after an exercise program, but it can also be light physical activity on its own for patients with rheumatoid arthritis. Even small physical tasks show the potential to help patients feel less tired and depressed, so it is important for clinicians to help their patients find a routine that works best for them. Even though their pain only allows them to do light stretching to begin with, it keeps them active and fits them into a routine.
Brady SM, Fenton SA, Metsios GS et al. Different types of physical activity are positively associated with indicators of mental health and psychological well-being in rheumatoid arthritis during COVID-19. Rheumatol Int. Published online November 30, 2020. doi: 10.1007 / s00296-020-04751-w