Osteoarthritis and Exercise

Introduction

Exercise group

Exercise therapy has a positive effect on patients with symptomatic osteoarthritis (OA). OA is a common form of arthritis that causes a significant health and economic burden. It commonly occurs in weight-bearing (WB) joints (such as hips and knees) and NWB joints (such as hands). exist People with osteoarthritis experience pain and stiffness in the affected joints. [1] [2]

1. Muscle strengthening and programs that include a combination of strength flexibility and aerobic exercise are more helpful for pain and disability than general activity such as walking.
2. Exercise therapy conferred benefits beyond pain and physical function, with modest effects on depression.
3. A program including exercise therapy and exercise education is recommended to reduce fear of activity and increase patient participation in the exercise program. [3] See Patient Education in Pain Management

Obesity, Exercise and OA

Obesity: risk factor for OA

Obesity is one of the most important risk factors for osteoarthritis symptoms and disease progression, especially knee involvement. [4]

1. Exercise helps maintain metabolic homeostasis. The excess adipose tissue that occurs in obesity increases the mechanical stress on weight-bearing joints and additionally leads to an imbalance in the secretion of adipokines, including leptin, adiponectin, visfatin, and resistin. These conditions create a low-grade inflammatory environment that eventually leads to cartilage breakdown.
2. Clinical trials have shown that an exercise program (including aerobic walking strength training, a second aerobic phase followed by a cool-off period) combined with diet results in significant weight loss, total fat mass, pain relief, and improvement in mobility. [5]

Be aware of knee OA: Obesity also results in thinner medial tibial cartilage compared to individuals with normal BMI. [6]

Physiotherapy

Therapeutic exercise (type/dosage) is determined by the physical therapist based on the needs of the patient and depends on age, weight, underlying fitness level, and severity of disease and comorbidities.

• Low-contact exercise is effective in controlling OA, it prevents maximum joint stress and improves muscle strength and joint stability. Avoid high contact sports.
• Mind-body exercises such as tai chi and yoga are also prescribed. [7]
• Gait aids can be recommended.
• Cryotherapy can be used as an adjunct to land-based exercises. [8]
• Education about weight management must be provided.
• In electrotherapy, transcutaneous electrical nerve stimulation is applied. [9]

Optimal exercise prescription will result in exercise compliance reducing the risk of symptom onset and maximizing outcomes. See Sticking to a Home Exercise Program

Aquatic Exercises

Hydrotherapy

Exercise done in water is called aquatics or hydrotherapy. It has several advantages over land-based exercises. Constant water temperature and hydrostatic pressure improve circulation and reduce tension in soft tissue contractures. it even Helps reduce muscle cramps and fatigue. Muscle strengthening is promoted because water resistance acts in the opposite direction of body movements that require greater muscle activity. Buoyancy reduces weight bearing, which helps reduce joint degeneration. It also gives a soothing feeling The environment of osteoarthritis patients who are reluctant to exercise. [10]

OA Hand

Hand OA

Osteoarthritis of the hand is a common musculoskeletal disorder. Its prevalence rises rapidly with age. It usually occurs at the first carpometacarpal joint. [11] The clinical features are pain and stiffness in the hand, decreased grip strength, and impaired functional status. main goal of A physical therapist will work on muscle strength to manage pain and improve functional status. [12] strongly prescribes hand orthoses. [11]

European League Against Rheumatism Adversary OA Recommendations

• Education and training in the ergonomic principles of activity rhythms and assistive device use should be provided to each patient.
• Therapists should consider exercises that improve function and strength, and reduce pain.
• Orthoses should be prescribed in thumb base OA to alleviate symptoms.
• Patients with long-term follow-up of hand OA should be as required by the patient. [13] .