Goals of exercise in a patient with osteoarthritis:
(1) to help to lose or maintain weight
(2) to avoid deconditioning and disability
(3) to improve mobility and stability
(4) to improve mood
(5) to reduce the experience of pain
Evaluation of the patient should include:
(1) overall severity of the arthritis
(2) distribution of the arthritis, especially in the knees, hips and back
(3) comorbid conditions such as coronary artery disease, COPD, renal insufficiency, diabetes and osteoporosis
(4) current medications
(5) identification of factors such as morning stiffness that may impact when exercise is done
(6) previous surgeries especially prosthetic joint placement
(7) previous injuries
(8) mobility issues, including history of falls, dizzness and syncope
(9) need for orthotics or mobility aids
A medical clearance should be obtained if significant medical problems exist. A patient with significant medical problems should not exercises alone.
An exercise program should avoid doing more harm to already damaged joints:
(1) excessive load or stress on arthritic joints
(2) placing stress on other joints
An exercise program:
(1) may include aquatic exercises, that help to reduce the load on affected joints
(2) may include exercises involving non-arthritic joints (such as use of an arm crank)
(3) should encourage long-term sustainability
