We were delighted to read the review by Viña et al. (2016) examining the essential role of physical activity in healthy ageing. The health benefits of physical activity are undeniable (Warburton et al. 2006) and international guidelines recommend that ageing adults should engage in physical activity (WHO, 2011). Nevertheless, we were concerned by one point stated by the authors, that there are conditions, such as osteoarthritis and rheumatoid arthritis, in which exercise is contraindicated and leads to acute phases of the disease, and the accompanying table (Fig. 2), within the same article, that labels osteoarthritis and rheumatoid arthritis as contraindications to exercise (Viña et al. 2016). Most chronic health conditions benefit from physical activity, arthritis being no exception. There is a strong consensus that physical activity benefits those with knee (Fransen et al. 2015) and hip (Fransen et al. 2014) osteoarthritis, as well as rheumatoid arthritis (Cooney et al. 2011). Guidelines for chronic disease management also voice that those with osteoarthritis can safely engage in aerobic exercise and resistance training and that those with rheumatoid arthritis can safely benefit from non‐weight‐bearing exercise (Durstine et al. 2016). Furthermore, the very article cited by the authors recommends resistance and aerobic training for both osteoarthritis and rheumatoid arthritis (Pedersen & Saltin, 2006). Certainly, activity reduction or modification is warranted during acute flare‐ups, but a diagnosis of arthritis should not be considered an absolute contraindication to exercise. Risks can be further mitigated by working with a qualified exercise professional (Warburton et al. 2013) and seeking medical clearance before beginning. In accord with the general message of this very well written review, physical activity is important in slowing down the onset of frailty and managing many chronic conditions, including arthritis.
Additional information
Competing interests
None declared.
Linked article This Letter to the Editor has a reply by Gomez‐Cabrera and Jose Viña. To read this reply, visit https://doi.org/10.1113/JP274722.
References
- Cooney JK, Law RJ, Matschke V, Lemmey AB, Moore JP, Ahmad Y, Jones JG, Maddison P & Thom JM (2011). Benefits of exercise in rheumatoid arthritis. J Aging Res 2011, 681640. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Durstine JL, Moore GE, Painter PL, Macko R, Gordon BT & Kraus WE (2016). Chronic conditions strongly associated with physical inactivity In ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities, 4th edn, ed. Moore GE, Durstine JL. & Painter PL, pp. 84–88. Human Kinetics, Champaign. [Google Scholar]
- Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M & Bennell KL (2015). Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 1, CD004376. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fransen M, McConnell S, Hernandez‐Molina G & Reichenbach S (2014). Exercise for osteoarthritis of the hip. Cochrane Database Syst Rev 22, CD007912. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pedersen BK & Saltin B (2006). Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports 16 (Suppl. 1), 3–63. [DOI] [PubMed] [Google Scholar]
- Viña J, Rodriguez‐Mañas L, Salvador‐Pascual A, Tarazona‐Santabalbina FJ & Gomez‐Cabrera MC (2016). Exercise: the lifelong supplement for healthy ageing and slowing down the onset of frailty. J Physiol 594, 1989–1999. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Warburton DE, Charlesworth SA, Foulds HJ, McKenzie DC, Shephard RJ & Bredin SS (2013). Qualified exercise professionals: best practice for work with clinical populations. Can Fam Physician 59, 759–761. [PMC free article] [PubMed] [Google Scholar]
- Warburton DE, Nicol CW & Bredin SS (2006). Health benefits of physical activity: the evidence. CMAJ 174, 801–809. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WHO (2011). Information sheet: global recommendations on physical activity for health 65 years and above (http://www.who.int/dietphysicalactivity/physical-activity-recommendations-65years.pdf?ua=1). World Health Organization. [PubMed]