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What is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an auto immune disease that causes inflammation in the joints (Perez-Sousa et al., 2023). Symptoms of RA are pain, fatigue, loss of capacity, and decreased quality of life (Perez-Sousa et al., 2023). Alberta Rheumatology (2025) recommends regular exercise as a holistic treatment to maintain joint stability and muscle strength, as well as education and knowledge about the disease.

Figure 4

 

Rheumatoid Arthritis: An Overview

Note. Source: (Alberta Rheumatology, 2010).

How does Pain Effect Physical Activity and Leisure Participation?

​The pain symptoms associated to RA can lead to a fear of pain and exacerbating it with physical activity (Ester et al., 2025). This pain has further effects such as:

​

•Pain causes changes to the brain on a molecular, cellular, and synaptic level.

•Pain causes depressive changes to cortex and thalamus.

•Pain effects the ability to participate in activities of daily living and social relationships.

•Pain creates a fear of pain and movement that causes pain.

•Pain contributes to a decreased desire to perform activities of daily living and socialization which in turn impacts quality of life and can lead to further impairment/disability.

(Perez-Sousa et al., 2023)

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Figure 5

 

Fear-Avoidance Model

Note. Source: (Rayner, 2005).

How Can Clients with RA engage in Physical Activity and Leisure?

Clients with RA should focus on physical movements that do not cause pain, help to decrease pain perceptions, and are low impact for the joints (Perez-Sousa et al., 2023). Aquafit is a great example of a physical activity for RA and can also be a fun social leisure activity (Perez-Sousa et al., 2023)

Figure 6

 

Aquafit.

Note. Source: (Wix, n.d.).

What are the Benefits of Aquatic Exercise for Women with RA?

  • Aquatic exercise increases physical fitness and functional capacity.

  • Aquatic exercise decreases perceived pain.

  • Aquatic exercise improves depression symptoms and increases quality of life.

(Perez-Sousa, 2023)

Figure 7

 

Swimmer.

Note. Source: (Wix, n.d.).

What is Aquatic Exercise?

Aquatic exercise is any exercise that occurs in water, like Aquafit/Aqua Aerobics (Verhagen et al., 2012). Cardiovascular and flexibility exercises similar to regular aerobics are completed in water, with usage of pool noodles and water dumbbells for extra resistance (Places Leisure, 2025). Classes are usually forty-five minutes long and you can move at your pace (Places Leisure, 2025). There is usually a ten minute warm-up and a five minute cool down after a thirty minute main workout (Perez-Sousa et al., 2023). Aquafit/Aqua Aerobics occurs in a fun group setting with music and can contribute to a positive social experience (Perez-Sousa et al., 2023).

Figure 8

 

Aqua Aerobics

Note. Source: (Everyone Active, 2020).

What Makes Exercise in Water Different?

Aquatic exercise is low impact on the joints due to the floatation factor of water (Verhagen et al., 2012). This floatation factor and buoyancy of water reduces the load on bones and joints, and allows for an ease of body weight movements (Verhagen et al., 2012). Water also provides natural resistance, which helps to strengthen muscles and decrease the load on the joints (Verhagen et al., 2012). Muscle relaxation is promoted by water and movement patterns in water cause no pain or decrease pain perceptions which is advantageous for those with RA (Perez-Sousa et al., 2023).

Figure 9

 

Woman Floating in Pool.

Woman Floating in Pool

Note. Source: (Wix, n.d.).

How does Rheumy Wellness Address Physical Activity Leisure Barriers for Clients with RA?

Physical activity leisure barriers for clients with RA are:

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  • Pain

  • Fear of pain

  • Fatigue

  • Timing of classes

  • Inaccessibility of facilities

  • No encouragement

  • Boring/not fun

  • Lack of social support

  • No convenient facilities

  • Lack of motivation

  • Temperature of water

  • Unsure of safe exercise

  • Lack of instruction/exercise programs

  • Cost

  • Lack of child care

  • Lack of access

 

(Veldhuijzen van Zanten et al., 2015)

The research and information above shows how Aquafit can decrease pain, the fear of pain, and fatigue (Perez-Sousa et al., 2023). It addresses that Aquafit is a safe form of exercise for those with RA and is performed in a structured class for instruction and instructor support (Perez-Sousa et al., 2023). Because of the nature of Aquafit, it can be a fun, motivating class, with built in social support (Perez-Sousa et al., 2023). The Aquafit Locator Tool aims to assist in finding Aquafit classes with childcare available, low cost or free options, warm temperature classes, different timings of classes, and improve access to Aquafit.

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