The series of exercise for Osteoarthritis with different localisation

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The series of exercise for Osteoarthritis with different localisation

According to JAMA, over 10 million Americans are affected by knee osteoarthritis. Most commonly hitting a population age 45 and higher this condition occurs as the cartilage in the knee wears away which eventually causes bone on bone contact. Most common complaints include joint stiffness, joint swelling, and pain. Knee osteoarthritis can be diagnosed via radiography which indicates boney cysts, narrowing joint space, and sclerosing of the bone.

The exercises in osteoarthritis (OA) are therapeutic approach with proven effectiveness. On the other hand, the various disease form, the lack of established consensus and system for patient education limit the widespread utilization of therapeutic exercises in clinical practice. The mode of action of therapeutic activity in OA includes the following components e. g., neuromuscular (enhancement of proprioception, muscle strength, and joint stability), intra-articular (prevention of cartilage degeneration, anti-inflammatory effect, recovery of the joint fluid quality), periarticular, general health to reduce cardiovascular risk and psychological components. The main exercises, which are applied in OA patients are stretching exercises, the range of motion exercises, analytic exercises for muscle strengthening (isometric and isotonic) and aerobic activities (walking, cycling, and swimming).

The recommended exercise programmes have to be individualized according to patient age, the severity of OA and the presence of concomitant diseases. The analytic exercises for enhancement of muscle strength in hip OA aim to affect the adductors, flexors, abductors, and extensors of the hip joint. In knee OA, the target muscle groups are thigh muscles (quadriceps muscle and a posterior group of thigh muscles), calf muscles (triceps surae muscle) as well as muscles around the hip joint. There are no established programmes for therapeutic exercises regarding the intensity, frequency, the degree and the interval for increasing of joint load. No significant variation in the efficacy of group vs. individual exercise programmes has been noticed. The main types of exercises used in OA are as follows: stretching exercises for muscle strength, the range of motion and aerobic exercises. In OARSI recommendations (2010), it is underlined that aerobic exercises and those for muscle strength have moderate efficacy in knee OA for pain relief e. g., ES (effect size) - 0.52 (for aerobic exercises) and 0.32 (for strengthening exercises). The ES for functional improvement is 0.46 for the aerobic exercises and 0.32 for the strengthening exercises.

The data for the role of therapeutic activities in hip OA are scarce. An effect on pain has been observed (ES-0.38) but without improvement of functional capacity. Remedial exercises have low to complicated moderate efficacy in patients with OA. They should be an obligatory part of the therapeutic regimens of the patients, which requires close collaboration between rheumatologists, general practitioners, and physiotherapists as well as the establishment of a system for patient education.


Curr Rheumatol Rev. 2017 Aug 10.

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Original title of the article:

Exercise programmes for osteoarthritis with different localization


Lambova; S.

Therapeutic, Osteoarthritis, Knee, Therapeutic exercises, Effectiveness, Efficacy, Intra-articular
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