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Monday, 1 February 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Rheumatoid Arthritis: Life style modification according herbal and TCM medicine specialist

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).

Types of Musculo-Skeletal disorders in elder(2)
1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia

Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs)  affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).


                            The Treatment

B. Treatment in herbal and traditional Chinese medicine
B.1. Life style modification according herbal and TCM medicine specialist
Life style modification has shown to be beneficiary for patients with Rheumatoid Arthritis to improve musculoskeletal and bone health and reduce disability. Dr. Jones G. and the research team at the joint study lead by University of Tasmania said" Lifestyle is of considerable importance in the first two and there is emerging evidence for rheumatoid arthritis despite it not traditionally being considered a lifestyle disease"(205). Modern herbal and TCM medicine specialists may suggest the following
B.1.1. Maintain balance weight
Maintain healthy weigh is important not only for reduce cost of treatment according to the study of retrospective analysis of 66 patients from a Spanish 1,000 beds-hospital Rheumatology Clinic Service(206) but also attenuate the risk of motility in patient with rheumatoid arthritis(207).
Dr. Baker JF and the research team at the joint study lead by Philadelphia VA Medical Center and University of Pennsylvania said" . Weight loss at an annualized rate of ≥3 kg/m(2) was associated with the greatest risk of death (HR 2.49, 95% CI 1.73-3.57, P < 0.001). Low BMI (<20 kg/m(2) ) in patients with a history of obesity (>30 kg/m(2) ) was associated with the greatest risk (HR 8.52, 95% CI 4.10-17.71, P < 0.001)(208).
In fact, many scientists have concerned for the rapidly increasing prevalence of obesity may contribute to recent increase in the incidence of  rheumatoid arthritis(RA)(209).

B.1.2. Exercise
Exercise, today is less popular leisure-time activity in many countries throughout the Western world, especially in the youth due to promotion of information collection through mobile phone. Exercise as medicine has been found to benefit to many forms of chronic diseases, including rheumatoid arthritis(210). Dr. Pedersen BK and Dr.Saltin B. Said" Considerable knowledge has accumulated in recent decades concerning the significance of physical activity in the treatment of a number of diseases,....... muscle, bone and joint diseases"(211).
Arobic capacity and/or muscle strength training(212), physical training exercise(213) are recommended as routine practice in patients with RA. In fact, according to the Bowman Gray School of Medicine, therapeutic exercise performance in patient with rheumatoid arthritis have shown in improving aerobic capacity, strengthening muscles, improving endurance and increasing flexibility(214).

B.1.3. Quite smoking
Smoking is a risk factor for RA,and heavy smokers, according to the Kobe University Graduate Schoolof Medicine(217)(218)
Smoking has been found to induce many forms of lung disease, and cancer,. According to statistic, smoking cause death of over 83% of patient with lung cancer.  Recent study suggested of the associated of lung diseases suchas bronchiectasis and unexplained dyspnea as predictor for the future development of rheumatoid arthritis, due to inflammation induced by external triggers (such as smoking) (215).
In a total of 857 patients, for determination of the effects of cigarette smoking in RA disease severity,pack years of cigarette smoking was significantly associated with rheumatoid factor seropositivity and radiographic erosions but less severe radiographic disease seemed to be more strongly associated with cigarette smoking than more severe disease(216).

B.1.4. Reduced intake of coffee
Coffee, one of many flavor drink in many culture may be associate to risk of rheumatoid arthritis, as coffee drunk daily was found directly proportional to the prevalence of RF positivity in dose depend-manner, according to the National Public Health Institute in a cohort of 18 981 men and women who had neither arthritisnor a history of it at the baseline examination in 1973-76. Up to late 1989(218). Recent study by the University of Alabama at Birmingham also suggested that decaffeinated coffee intake is independently and positively associated with RA onset(219).
Other studies insisted of little evidence of an association between coffee, decaffeinated coffee, or tea consumption and the risk of RA among women, including the Harvard Medical School, and Brigham and Women's Hospital(220).

B.1.5. Moderate alcohol drinking
Intake of moderate alcohol has been found to induce diseases protection. According to the Brigham and Women's Hospital and Harvard Medical School, long term moderate alcohol drinking are also associate to reduce risk of RA(221) and study of 34,141 women born between 1914 and 1948, followed up from 1 January 2003 to 31 December 2009 by the Institute of Environmental Medicine(222).


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References
(201) Selective JAK inhibitors in development for rheumatoid arthritis by Norman P1.(PubMed)
(202) Targeting the Janus kinases in rheumatoid arthritis: focus on tofacitinib by Yamaoka K1, Tanaka Y.(PubMed)
(203) Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery by Grennan DM1, Gray J, Loudon J, Fear S.(PubMed)
(204) 2012 Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthritis.[Article in English, Portuguese] by da Mota LM1, Cruz BA, Brenol CV, Pereira IA, Rezende-Fronza LS, Bertolo MB, de Freitas MV, da Silva NA, Louzada-Júnior P, Giorgi RD, Lima RA, da Rocha Castelar Pinheiro G; Brazilian Society of Rheumatology.(PubMed)
(205) Lifestyle modifications to improve musculoskeletal and bone health and reduce disability--a life-course approach by Jones G1, Winzenberg TM2, Callisaya ML3, Laslett LL4.(PubMed)
(206) Cost analysis of biologic drugs in rheumatoid arthritis first line treatment after methotrexate failure according to patients' body weight.[Article in English, Spanish] by Román Ivorra JA1, Ivorra J1, Monte-Boquet E2, Canal C3, Oyagüez I4, Gómez-Barrera M5.(PubMed)
(207) Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation by Escalante A1, Haas RW, del Rincón I.(PubMed)
(208) Weight Loss, the Obesity Paradox, and the Risk of Death in Rheumatoid Arthritis. by Baker JF1, Billig E2, Michaud K3, Ibrahim S1, Caplan L4, Cannon GW5, Stokes A6, Majithia V7, Mikuls TR8.(PubMed)
(209) Contribution of obesity to the rise in incidence of rheumatoid arthritis by Crowson CS1, Matteson EL, Davis JM 3rd, Gabriel SE.(PubMed)
(210) Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases by Pedersen BK1, Saltin B2.(PubMed)
(211) Evidence for prescribing exercise as therapy in chronic disease by Pedersen BK1, Saltin B.(PubMed)
(212) Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis by Hurkmans E1, van der Giesen FJ, Vliet Vlieland TP, Schoones J, Van den Ende EC.(PubMed)


(213) Effects of a group-based exercise and educational program on physical performance and disease self-management in rheumatoid arthritis: a randomized controlled study by Breedland I1, van Scheppingen C, Leijsma M, Verheij-Jansen NP, van Weert E.(PubMed)
(214) Therapeutic exercise for rheumatoid arthritis and osteoarthritis by Semble EL1, Loeser RF, Wise CM.(PubMed)
(215) The lung in rheumatoid arthritis, cause or consequence? by Chatzidionisyou A1, Catrina AI.(PubMed)
(216) Cigarette smoking and rheumatoid arthritis severity by Saag KG1, Cerhan JR, Kolluri S, Ohashi K, Hunninghake GW, Schwartz DA.(PubMed)
(217) Impact of smoking as a risk factor for developing rheumatoid arthritis: a meta-analysis of observational studies by Sugiyama D1, Nishimura K, Tamaki K, Tsuji G, Nakazawa T, Morinobu A, Ku) .(PubMed)
(218) Coffee consumption, rheumatoid factor, and the risk of rheumatoid arthritis. by Heliövaara M1, Aho K, Knekt P, Impivaara O, Reunanen A, Aromaa A.magai S(PubMed)
(219) Coffee, tea, and caffeine consumption and risk of rheumatoid arthritis: results from the Iowa Women's Health Study by Mikuls TR1, Cerhan JR, Criswell LA, Merlino L, Mudano AS, Burma M, Folsom AR, Saag KG.(PubMed)
(220) Coffee consumption and risk of rheumatoid arthritis by Karlson EW1, Mandl LA, Aweh GN, Grodstein F.(PubMed)
(221) Alcohol consumption and risk of incident rheumatoid arthritis in women: a prospective study. by Lu B1, Solomon DH, Costenbader KH, Karlson EW.(PubMed)
(222) Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study by Di Giuseppe D1, Alfredsson L, Bottai M, Askling J, Wolk A.(PubMed)