Remote classes such as yoga, Pilates, and tai chi are beneficial for people with musculoskeletal problems such as osteoarthritis (OA), rheumatoid arthritis (RA), and osteoporosis, according to research presented at the American College of Rheumatology 2021 annual meeting.
After attending biweekly 60-minute low-intensity Zoom fitness classes at six-week increments, participants improved physically and became more socially active, say researchers at the Hospital for Special Surgery (HSS) in New York City.
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6-Week Remote Program Improved Mobility, Pain, Stiffness, Other Symptoms
Out of the 355 people assessed (among a total of 6,779 participants), 161 self-reported a musculoskeletal condition. Affecting the joints, bones, or muscles, musculoskeletal conditions include inflammatory arthritis and other chronic conditions associated with pain, functional limitations, and disability.
Participants were mostly female, older than 60, and white. That group reported that with any level of participation at every six-week virtual exercise session, they achieved:
- 5 percent reported a decrease in overall pain
- 5 percent decrease in joint stiffness
- 7 percent decrease in pain while walking
- 8 percent decrease in fatigue
Those who said they attended twice a week or more for six weeks reported even more improvement:
- 11 percent decrease in pain intensity
- 12 percent decrease in stiffness
- 9 percent decrease in fatigue and decreased pain interference with all aspects of daily living, including general activity levels, mood, walking ability, normal work, relations with others, sleep, and overall enjoyment of life
Livestreaming Exercise Classes Versus On-Demand Online Classes
Live remote exercise programs offer a two-way interactive experience: participants connect to a video conference or meeting remotely with a computer, smartphone, or tablet device, usually from their own home. During the class, people may have the opportunity to talk with others and get personal feedback from the instructor, who can see and hear them via the device’s camera and microphone.
HSS offered a remote, live class that had to be taken at a scheduled time but provided direct interaction with the instructor and other students. Unlike prerecorded classes online (often free) that allow you to participate whenever you choose, the live classes allow for interaction and professional oversight. Online or on-demand fitness classes are similar to the “one-way” classes offered via recording on a videotape or DVD.
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Virtual, Low-Impact Programs Offer Socializing and Support as Well
According to the Centers for Disease Control (CDC), loneliness affects more than one-third of adults age 45 and and up and nearly one-fourth of adults age 65 and older. (Obviously, the COVID-19 pandemic made human connection vastly more difficult.) There are many health risks associated with social isolation, including dementia, mental health issues, and premature death.
A study published in June 2017 in Quality in Ageing and Older Adults found a strong connection between social isolation and loneliness and chronic musculoskeletal diseases. To work on that, the HSS research team built a social component into their exercise programs. “We made sure our classes were structured to increase interactions with others. We promoted a dialogue before the class began so people could talk and catch up with each other. They said it helped promote social connections,” says Titilayo Ologhobo, MPH, the director of outcomes and data analytics at HSS and the new study’s author.
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‘Flexibility and Convenience’ and Other Factors Made the Fitness Classes Doable
The team did not collect data comparing virtual and in-person classes, but the feedback they received was that people enjoyed the virtual program because of the time flexibility and the convenience of working out at home. Other barriers to exercise known to challenge people with arthritis and other conditions are physical accessibility, travel conditions, and pain with movement. Research published in Physical Therapy and Rehabilitation Journal found that people with osteoarthritis experienced the following obstacles to exercising regularly at in-person classes.
- Weather Many people with OA are sensitive to cold and damp, and don’t feel well enough to exercise on cold days or feel safe enough to go outside on icy, damp days.
- Accessibility of exercise facilities The actual space, the classes, or accessibility may not be user-friendly for people with arthritis challenges. Stairs, for example, can be a deal-breaker.
- Transportation Some people with arthritis have trouble driving and are dependent on other people for rides because there's no other transport.
- Cost Gym memberships can be expensive. Virtual programs, however, are either free or at least more affordable.
- Self-image People may feel uncomfortable in a gym because of poor body confidence. They may be embarrassed by how they look or by their skill level. A virtual class allows them to control how much they want to expose themselves.
Where to Find Low-Impact Remote Fitness Classes
Ologhobo stresses that you shouldn’t start any new exercise regimen before consulting with your healthcare provider. Your doctor can help you assess whether a given program is appropriate for your level of fitness and health. If you have moderate or severe disease, you may want to check in with a physical therapist who can evaluate the safety and efficacy of a given program for you and suggest specific resources. Here are some virtual sites that offer gentle exercise. Consider a trial class or trial membership before you make a financial commitment. If none of these work for you, ask your healthcare provider or physical therapist for suggestions.
- Hospital for Special Surgery
- Obé Live and on-demand Pilates classes with a free trial
- Tai Chi Foundation Offers free live online classes
- Vitality Society Live classes in yoga, Pilates, and tai chi, aimed at people 60 and older
- YMCA 360 Check with your local branch; many offer livestream and on-demand classes.
- YogaWorks Daily livestream and on-demand classes
Rheumatologists and Other Doctors, Take Note
The takeaway for rheumatologists and others who care for people with painful musculoskeletal conditions appears to be to encourage participation in these types of classes. “Amid the uncertainties caused by the pandemic, shifting to virtual programming provided older adults with musculoskeletal conditions continued access to effective community programs and reduced the negative impact of isolation. Implementation of virtual online exercise programs can be successful when assessing the needs of your target audience, considering potential barriers to program participation, and tailoring virtual programs to meet patients’ specific needs,” Ologhobo said in a press release.
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