Exercising with arthritis
Low-impact activities, including water-resistive exercises or bicycle training, may enhance peripheral muscle tone and strength and cardiovascular endurance, without causing excessive force across, or injury, to joints. exercising with arthritis Rumatoid-arthritis. Studies of nursing home and community-dwelling elderly clearly demonstrate that one additional important benefit of exercise is a reduction in the number of falls. (top of page) Surgical Management Patients in whom function and mobility remain compromised despite maximal medical therapy, and those in whom the joint is structurally unstable, should be considered for surgical intervention. Patients in whom pain has progressed to unacceptable levels-that is, pain at rest and/or nighttime pain-should also be considered as surgical candidates. exercising with arthritis Finger pain. Surgical options include arthroscopy, osteotomy and arthroplasty. Arthroscopic removal of intra-articular loose bodies and repair of degenerative menisci may be indicated in some patients with knee OA. Tibial osteotomy is an option for some patients who have a relatively small varus angulation (less than 10 degrees) and stable ligamentous support. exercising with arthritis Arthritis mutilans. Total knee arthroplasty is recommended for patients with more severe varus, or any valgus, deformity and ligamentous instability. Arthroplasty is also indicated for patients who have had ineffective pain relief following a tibial osteotomy, and for those with advanced hip OA. Patients who have not yet developed appreciable muscle weakness, generalized or cardiovascular deconditioning and who would medically withstand the stress of surgery are ideal surgical candidates. In contrast, full mobility and function may not be realistically expected in patients with significant cognitive impairment or symptomatic cardiopulmonary disease, since these conditions can impede post-operative rehabilitation. (top of page) Functional Assessment Several questionnaires have been established as validated, reliable research instruments for assessing functional outcomes in patients with arthritis. These include the Lequesne index, the Western Ontario McMaster Arthritis scale (WOMAC), activities of daily living (ADL), etc. Several performance-based tests of function can be done rapidly and easily in the office, however, and may be more sensitive in predicting impending disability than direct questions about disability and impairment. Such measures include grip strength, a timed walk, sequential chair-stands, and others listed below. . These tests can provide the clinician with valuable information on the patient�s current level of function, as well as serve longitudinally to assess decline in function. (top of page) Future Directions The development of selective COX-2 inhibitors has been an exciting advance in the management of pain and inflammation, as discussed above.
Exercising with arthritis
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