Patients with rheumatoid arthritis often experience symptoms of depression, anxiety, and fatigue. These symptoms may be exacerbated during the coronavirus disease 2019 (COVID-19) pandemic, during which the resulting fear and isolation have also contributed to feelings of depression and burnout.
Clinicians often recommend physical activity to patients with rheumatoid arthritis to help manage pain and soreness, but it can also be beneficial for their mental health and overall quality of life. What are some physical activities, exercise or otherwise, that physicians can recommend to their patients with rheumatoid arthritis exhibiting who may be experiencing mental fatigue?
Though certain activities may be too strenuous for them, light physical activity performed around the house can be more helpful than patients realize. A recent study published in Rheumatology International found a positive correlation between physical activity and the psychological well-being of patients with rheumatoid arthritis during the COVID-19 pandemic.¹ A significant portion of the activity they measured was designated as “light physical activity” and included household chores like 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 correlated 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 provides an opportunity to engage in physical activity outdoors, which is something that has been more difficult during the COVID-19 pandemic. Walking is an exercise that isn’t too strenuous and lets individuals perform it at their own pace.
Cycling is another outdoor activity that patients can engage in during the COVID-19 pandemic. The researchers included cycling as part of the “exercise” category in 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 clinicians recommend to patients with rheumatoid arthritis become more difficult to do amid 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 therapy that can help alleviate symptoms. It’s also a versatile activity for patients with rheumatoid arthritis, with routines and poses that can be adjusted based on an individual’s needs. Online yoga classes also provide an opportunity for individuals to connect with others, which may also help with the feelings of isolation experienced by many during the COVID-19 pandemic.
Stretching should be done before and after an exercise regimen but by itself may also be a light physical activity for patients with rheumatoid arthritis. Even small physical tasks show the potential to help patients feel less fatigued and depressed, so it is important for clinicians to help their patients find a routine that works best for them. Even if their soreness only allows them to do light stretching to start, it is keeping them active and getting them adjusted to 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 wellbeing in rheumatoid arthritis during COVID-19. Rheumatol Int. Published online November 30, 2020. doi:10.1007/s00296-020-04751-w