Rather than avoid physical activity, an approach used by many people with rheumatoid arthritis or osteoarthritis, "patients must exercise," said Debra R. Lappin, chair of the Arthritis Foundation.

The 1990-1991 National Health Interview Survey indicates that arthritis was present in about 20% of U.S. adults. More than one third of adults with arthritis engaged in no leisure-time physical activity, a substantially higher percentage than that in persons without arthritis. Another third were physically active on an irregular basis (MMWR Morb Mortal Wkly Rep. 1997; 46:389-93).

Lappin pointed to studies showing that people with arthritis can adapt to increased levels of physical activity without adverse effects; physical activity produces improvements in muscle function, cardiorespiratory capacity, and physical performance. Older adults with arthritis can experience subjective and objective improvements in their condition through physical activity.

The Arthritis Foundation supports aquatic exercise programs at YMCAs across the country-these programs are a good start for patients who do not exercise, according to Lappin. Once comfortable with water-based exercise, patients can move to nonaquatic, weight-bearing exercises to avoid osteoporosis and then to aerobic conditioning, she suggested.

The Arthritis Foundation lists local exercise programs for people with arthritis at 800-283-7800 or on the World Wide Web (http://www.arthritis.org).

-Cori Vanchieri