People with rheumatoid arthritis, or RA, are more likely to be physically active if they believe it will help manage their disease, according to new research.

“Knowledge and motivation are kind of related. A lot of people don’t understand that you can be physically active and not hurt your joints. I don’t think everybody believes that,” explains Rowland Chang, MD, a rheumatologist and professor at the Northwestern University Feinberg School of Medicine in Chicago.

In a study published online in Arthritis Care & Research, Dr. Chang and his colleagues found that, despite a multitude of studies showing the benefits of physical activity, many RA patients remain physically inactive due to a variety of factors including age, pain, functional limitations and lack of education about the benefits of exercise.

Patients may not believe in the benefits because they worry about pain and hurting already damaged joints, says Dr. Chang. And it wasn’t so long ago that RA patients were given different advice. “In the 1950s, if you had RA, it was not uncommon for you to be hospitalized [or prescribed bed rest.] It’s only been in the last 30 years that people realized that is not the right idea,” Dr. Chang explains.

Now we know that a lack of physical activity can make RA worse and increase the risk of cardiovascular disease. Dr. Chang and his colleagues wanted to better understand the knowledge gap about physical activity among people with RA in the hope that this information could lead to interventions to get more patients moving.

The researchers looked at three potential predictors of physical activity in 185 adult RA patients. They examined the extent to which subjects believed physical activity was helpful in managing RA, whether they felt confident that they could be physically active (what they called “motivation”), and whether they had worries – about their ability to do or not do the things they enjoy or their ability to work, for instance – that influenced their activity level. Participants were asked questions in these areas. Their activity levels were also measured over the course of a week by an accelerometer, which tracks when someone is moving and the intensity of that movement.

Using that data, researchers discovered that beliefs and motivation related to physical activity carried a lot of weight. “There was a significant increase in physical activity if you had high belief and high motivation,” Dr. Chang explains.

The challenge facing health professionals is getting more patients to learn and believe that exercise is a key tool in the prevention and management of RA as well as many other diseases.

A study of more than 13,000 women, published in the Archives of Internal Medicine, found that those who had the highest physical activity levels compared with those with the lowest in middle age had better overall health as they got older.

“What we found is, at age 60 or younger, if you engage in moderate physical activity – such as brisk walking for 30 minutes a day, seven days a week – you’ll have much better odds of achieving successful aging than [someone] who didn’t do that,” explains study author Qi Sun, MD, an instructor of medicine at Harvard Medical School in Boston. For this study, successful aging was defined as the absence of cancer, diabetes or other major chronic diseases, as well as no evidence of physical disabilities, impairments in cognitive function or mental health limitations by the age of 70.

Studies like these, however, may resonate more with the scientific community than the general population.

“Most of the studies mean a lot to physicians and scientists [who have evidence] the portion of the population that exercises does better. But on an individual basis, people may struggle with how much is enough for them. There isn’t an automatic feedback mechanism,” explains Michael McConnell, MD, a professor of cardiovascular medicine at Stanford University School of Medicine in California.

Dr. McConnell is the lead author of a study that found older men and women who engaged in the highest level of physical activity – doing things like playing tennis, swimming and jogging – experienced more heart benefits than the least active group. His study, published in the April 2011 Journal of the American College of Cardiology: Cardiovascular Imaging, also found the heart arteries benefit from everyday physical activities, such as casual walking, not just hard-core exercising. That’s something he now stresses to his patients.

Dr. Chang believes a lot of people with RA and other forms of arthritis are hesitant to become more physically active on their own. He recommends starting with the Arthritis Foundation’s Walk with Ease Program.

“In general, I think walking is something people feel comfortable doing – even people with RA and knee osteoarthritis. Then I would say, if you have trouble and you feel your joints are getting worse because of walking – then that might be the time to talk to physician about seeing a physical therapist to find an exercise program that takes these problems into consideration,” Dr. Chang says.