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*Only for medical professionals to read for reference.
Tai Chi or Yoga? The exercise plan for patients with spondyloarthritis is so set! Over the years, new research data has continued to support a familiar proverb-life is movement
.
Physical activity can not only delay aging, but also delay death.
People who love exercise usually live longer
.
Especially for some patients with chronic diseases, the risk of serious health problems such as heart disease, type 2 diabetes, obesity and certain cancers is also lower, and the group of patients with spondyloarthritis benefits without exception
.
At the "ACR 2021 Youth Committee of the Society of Rheumatology" held by the medical community, Director Zhao Ling from the Department of Rheumatology and Immunology of the First Hospital of Jilin University explained the importance of exercise for patients with spondyloarthritis It also summarized a reasonable exercise plan based on the content of the meeting
.
Higher levels of physical fitness will delay all-cause mortality.
Director Zhao Ling gave a set of data to illustrate the advantages of exercise: it can reduce deaths by 1/10, breast cancer by 1/8, and colorectal by 1/8.
Cancer, 1/12 diabetes and 1/15 heart disease
.
If we regard exercise as a kind of "drug", we can think of it as the most effective "drug", and for people with chronic diseases, physical exercise can help control these diseases and complications
.
Sports exercise generally includes several types.
Among them, only daily leisure, cultural and sports activities have the above-mentioned benefits, and work and occupational activities do not significantly benefit people
.
Facing the controversy: Why does exercise benefit axSpA patients? Exercise benefits the general population.
There is no controversy.
Is it beneficial to patients with axial spondyloarthritis (axSpA)? At the ACR 2021 conference, professors have come up with research data to demonstrate
.
In a study of injecting E.
coli endotoxin into healthy people, subjects were divided into resting group and exercise group.
The level of tumor necrosis factor-α (TNF-α) in the latter was significantly lower than the former
.
This shows that physical exercise can achieve anti-inflammatory effects by inhibiting the production of TNF-α
.
And another study found that inflammatory back pain in patients with axSpA can be improved with exercise, with an OR of 23.
1
.
Figure 1 The clinical features of inflammatory back pain.
Exercise can work, perhaps related to the Goldilocks zone (habitable zone) model of human anatomy
.
Figure 2 Goldilocks zone
.
A model for the interaction of mechanical stress factors, genetic and environmental factors in the pathogenesis of SpA enthesitis
.
It can be seen from Figure 2 that the patient takes physical exercise when the systemic or local inflammatory factors and immune cells interact.
On the one hand, the patient can enjoy the aforementioned benefits brought by the exercise; on the other hand, the patient will face the potential Mini-trauma and inflammation of the driving site have the potential to promote the formation of new bone.
At this time, the patient may also have an unstable attachment point due to the reduction of Goldilocks zone, or a high pressure on the attachment point
.
Director Zhao Ling hereby reminds that for most normal people and patients, exercise plays a positive role, but in some patients, exercise is a double-edged sword
.
Guideline evaluation: The role of exercise in patients with AS/AxSpA.
The 2019 ACR guidelines point out the general auxiliary management of patients, that is, unsupervised back exercises, formal group or individual self-management education, fall evaluation/consultation, and regular use of verified Ankylosing spondylitis (AS) disease activity measurements and C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) are monitored
.
In addition, it can be adjusted throughout the process according to the specific conditions of the patient
.
In the 2015 guidelines of the ACR/American Spondylitis Association (SAA)/Spondroarthritis Research and Treatment Network (SPARTAN), experts recommend (medium-quality evidence): 1.
Adults with active AS should perform plane exercise instead of Curved exercises, and back exercises are not recommended; 2.
Adults with stable AS should perform unsupervised back exercises
.
In addition to the guideline recommendations, the experts at the meeting also summarized the latest evidence of different types of sports in AS/SpA
.
Zhao, director summarize and recommend these types of sports: Tai Chi, Swiss ball, yoga, walking, swimming, home exercise routine, aerobic exercise, plane motion (stretching, breathing) and so on
.
Studies have shown that exercise can improve the disease activity scores of Ankylosing Spondylitis Disease Activity Index (BASDAI), Pasteur's Ankylosing Spondylitis Function Index (BASFI) and Visual Analog Scale (VAS-pain)
.
Expert recommendation: What exercise strategy should the patient adopt? The experts first referred to the 2018 European Union Against Rheumatism (EULAR) recommendations on physical activity for patients with inflammatory arthritis and osteoarthritis: Recommendation 1: Based on clear and personalized personal goals
.
Recommendation 2: Solve the obstacles and factors of general and specific diseases
.
Recommendation 3: Adapt to personal physical, social and psychological factors, including fatigue, pain, depression, and disease activity
.
Recommendation 4: Include behavior change methods, such as self-monitoring, goal setting, action plans, feedback, and problem solving
.
Recommendation 5: Consider different exercise methods according to people's preferences
.
The guidelines give ideas for formulating exercise programs.
On this basis, experts at the ACR 2021 meeting gave specific recommendations
.
Program specific content Multi-mode program aerobic/inspiratory training, mobility training, strength training, water sports, customized programs based on evaluation, long-term monitoring/guaranteeing safe dose settings/implementing compliance.
The situation between people cannot be generalized, which means never There is no once-and-for-all exercise strategy.
Multi-modal programs combined with customized evaluation-based programs are conducive to patients getting tailor-made dynamic programs
.
The ACR 2021 conference has ended.
Director Zhao Ling explained the exercise strategies for patients with spondyloarthritis in a simple way.
It not only strengthens patients' awareness of exercise, but also helps medical workers understand the pathological mechanism behind the disease
.
Human curiosity drives researchers to lift the veil of the disease time and time again.
Although spondyloarthritis has not been completely cured yet, it is believed that as research continues to deepen, we will be infinitely close to the bright prospect of low prevalence and high cure rate
.
Expert profile Zhao Ling, deputy director of the Department of Rheumatology and Immunology, the First Hospital of Jilin University
.
Deputy Chief Physician, Master's Supervisor, Doctor of Medicine
.
Member of the Youth Committee of the Chinese Society of Rheumatology, Member of the Standing Committee of the Rheumatology and Immunology Branch of the Asia-Pacific Society of Medical Bioimmunology, Member of the Rheumatology Related Imaging Group and Pediatrics Group of the Rheumatology and Immunology Branch of the Chinese Medical Doctor Association, Member of the Rheumatology and Immunorehabilitation Professional Committee of the Chinese Association of Rehabilitation Medicine, Member of the Infection Group and Ocular Immunology Group of the Rheumatology and Immunology Professional Committee of the Cross-Strait Medical and Health Exchange Association, and a member of the Chinese Rheumatism-Related Reproductive and Pregnancy Research Committee
.
Member of the Rheumatism Molecular Immunology Branch of the National Health Industry Business Management Association, member of the Immune Cell Therapy Engineering and Technology Branch of the Chinese Society of Biomedical Engineering, member of the Youth Committee of the Rheumatology Branch of the Jilin Medical Association, member of the Gout Professional Committee of the Jilin Provincial Health Management Society, Jilin Province Member of the Standing Committee of the Dry Eye Prevention and Treatment Professional Committee of the Bethune Volunteer Association, and an expert of the Medical Appraisal Committee of the Disability Grade of Veterans in Jilin Province
.
Tai Chi or Yoga? The exercise plan for patients with spondyloarthritis is so set! Over the years, new research data has continued to support a familiar proverb-life is movement
.
Physical activity can not only delay aging, but also delay death.
People who love exercise usually live longer
.
Especially for some patients with chronic diseases, the risk of serious health problems such as heart disease, type 2 diabetes, obesity and certain cancers is also lower, and the group of patients with spondyloarthritis benefits without exception
.
At the "ACR 2021 Youth Committee of the Society of Rheumatology" held by the medical community, Director Zhao Ling from the Department of Rheumatology and Immunology of the First Hospital of Jilin University explained the importance of exercise for patients with spondyloarthritis It also summarized a reasonable exercise plan based on the content of the meeting
.
Higher levels of physical fitness will delay all-cause mortality.
Director Zhao Ling gave a set of data to illustrate the advantages of exercise: it can reduce deaths by 1/10, breast cancer by 1/8, and colorectal by 1/8.
Cancer, 1/12 diabetes and 1/15 heart disease
.
If we regard exercise as a kind of "drug", we can think of it as the most effective "drug", and for people with chronic diseases, physical exercise can help control these diseases and complications
.
Sports exercise generally includes several types.
Among them, only daily leisure, cultural and sports activities have the above-mentioned benefits, and work and occupational activities do not significantly benefit people
.
Facing the controversy: Why does exercise benefit axSpA patients? Exercise benefits the general population.
There is no controversy.
Is it beneficial to patients with axial spondyloarthritis (axSpA)? At the ACR 2021 conference, professors have come up with research data to demonstrate
.
In a study of injecting E.
coli endotoxin into healthy people, subjects were divided into resting group and exercise group.
The level of tumor necrosis factor-α (TNF-α) in the latter was significantly lower than the former
.
This shows that physical exercise can achieve anti-inflammatory effects by inhibiting the production of TNF-α
.
And another study found that inflammatory back pain in patients with axSpA can be improved with exercise, with an OR of 23.
1
.
Figure 1 The clinical features of inflammatory back pain.
Exercise can work, perhaps related to the Goldilocks zone (habitable zone) model of human anatomy
.
Figure 2 Goldilocks zone
.
A model for the interaction of mechanical stress factors, genetic and environmental factors in the pathogenesis of SpA enthesitis
.
It can be seen from Figure 2 that the patient takes physical exercise when the systemic or local inflammatory factors and immune cells interact.
On the one hand, the patient can enjoy the aforementioned benefits brought by the exercise; on the other hand, the patient will face the potential Mini-trauma and inflammation of the driving site have the potential to promote the formation of new bone.
At this time, the patient may also have an unstable attachment point due to the reduction of Goldilocks zone, or a high pressure on the attachment point
.
Director Zhao Ling hereby reminds that for most normal people and patients, exercise plays a positive role, but in some patients, exercise is a double-edged sword
.
Guideline evaluation: The role of exercise in patients with AS/AxSpA.
The 2019 ACR guidelines point out the general auxiliary management of patients, that is, unsupervised back exercises, formal group or individual self-management education, fall evaluation/consultation, and regular use of verified Ankylosing spondylitis (AS) disease activity measurements and C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) are monitored
.
In addition, it can be adjusted throughout the process according to the specific conditions of the patient
.
In the 2015 guidelines of the ACR/American Spondylitis Association (SAA)/Spondroarthritis Research and Treatment Network (SPARTAN), experts recommend (medium-quality evidence): 1.
Adults with active AS should perform plane exercise instead of Curved exercises, and back exercises are not recommended; 2.
Adults with stable AS should perform unsupervised back exercises
.
In addition to the guideline recommendations, the experts at the meeting also summarized the latest evidence of different types of sports in AS/SpA
.
Zhao, director summarize and recommend these types of sports: Tai Chi, Swiss ball, yoga, walking, swimming, home exercise routine, aerobic exercise, plane motion (stretching, breathing) and so on
.
Studies have shown that exercise can improve the disease activity scores of Ankylosing Spondylitis Disease Activity Index (BASDAI), Pasteur's Ankylosing Spondylitis Function Index (BASFI) and Visual Analog Scale (VAS-pain)
.
Expert recommendation: What exercise strategy should the patient adopt? The experts first referred to the 2018 European Union Against Rheumatism (EULAR) recommendations on physical activity for patients with inflammatory arthritis and osteoarthritis: Recommendation 1: Based on clear and personalized personal goals
.
Recommendation 2: Solve the obstacles and factors of general and specific diseases
.
Recommendation 3: Adapt to personal physical, social and psychological factors, including fatigue, pain, depression, and disease activity
.
Recommendation 4: Include behavior change methods, such as self-monitoring, goal setting, action plans, feedback, and problem solving
.
Recommendation 5: Consider different exercise methods according to people's preferences
.
The guidelines give ideas for formulating exercise programs.
On this basis, experts at the ACR 2021 meeting gave specific recommendations
.
Program specific content Multi-mode program aerobic/inspiratory training, mobility training, strength training, water sports, customized programs based on evaluation, long-term monitoring/guaranteeing safe dose settings/implementing compliance.
The situation between people cannot be generalized, which means never There is no once-and-for-all exercise strategy.
Multi-modal programs combined with customized evaluation-based programs are conducive to patients getting tailor-made dynamic programs
.
The ACR 2021 conference has ended.
Director Zhao Ling explained the exercise strategies for patients with spondyloarthritis in a simple way.
It not only strengthens patients' awareness of exercise, but also helps medical workers understand the pathological mechanism behind the disease
.
Human curiosity drives researchers to lift the veil of the disease time and time again.
Although spondyloarthritis has not been completely cured yet, it is believed that as research continues to deepen, we will be infinitely close to the bright prospect of low prevalence and high cure rate
.
Expert profile Zhao Ling, deputy director of the Department of Rheumatology and Immunology, the First Hospital of Jilin University
.
Deputy Chief Physician, Master's Supervisor, Doctor of Medicine
.
Member of the Youth Committee of the Chinese Society of Rheumatology, Member of the Standing Committee of the Rheumatology and Immunology Branch of the Asia-Pacific Society of Medical Bioimmunology, Member of the Rheumatology Related Imaging Group and Pediatrics Group of the Rheumatology and Immunology Branch of the Chinese Medical Doctor Association, Member of the Rheumatology and Immunorehabilitation Professional Committee of the Chinese Association of Rehabilitation Medicine, Member of the Infection Group and Ocular Immunology Group of the Rheumatology and Immunology Professional Committee of the Cross-Strait Medical and Health Exchange Association, and a member of the Chinese Rheumatism-Related Reproductive and Pregnancy Research Committee
.
Member of the Rheumatism Molecular Immunology Branch of the National Health Industry Business Management Association, member of the Immune Cell Therapy Engineering and Technology Branch of the Chinese Society of Biomedical Engineering, member of the Youth Committee of the Rheumatology Branch of the Jilin Medical Association, member of the Gout Professional Committee of the Jilin Provincial Health Management Society, Jilin Province Member of the Standing Committee of the Dry Eye Prevention and Treatment Professional Committee of the Bethune Volunteer Association, and an expert of the Medical Appraisal Committee of the Disability Grade of Veterans in Jilin Province
.
