Chapter 2: MEDICAL ASPECTS EXERCISE AND ARTHRITIS Many scientific studies have proven exercise to be an effective and essential component in the comprehensive health care management program of individuals with arthritis (Kaptein, et al., 2013; Levy, et al., 2012; Wilcox, et al., 2015). Pain and stiffness tend to discourage people from exercising. However, without exercise, joints become more stiff and painful and the disease process has a tendency to progress. Exercise keeps bones, muscles and joints healthy while slowing the progression of the disease. Proper exercise promotes optimum joint flexibility, muscle strength and endurance, balance and coordination, and cardiovascular conditioning. Participating in an exercise program may also improve self-image and self-esteem. FORMS OF EXERCISE Exercise may take different forms, some of which are discussed below. Each form of exercise has benefits and may be part of a complete exercise program for individuals with arthritis, but keep in mind that each person is unique in goals, needs and abilities. ACTIVITIES OF DAILY LIVING (ADLs) Tasks an individual normally performs as part of a daily routine, such as cooking, gardening, dressing and climbing stairs. RECREATIONAL ACTIVITIES Hobbies, games and sports, such as walking, swimming and golf. FITNESS TRAINING Exercises and activities specifically designed to maintain or improve functional capacity or a predetermined fitness level. This form of training targets five main components: cardiorespiratory endurance, muscular strength, muscular endurance, flexibility and body composition. It often incorporates skill-related components as well. THERAPEUTIC EXERCISE Specific exercises prescribed and guided by a health care professional to correct a specific problem or achieve a specific goal, such as increasing joint mobility, muscle strength and endurance. EXERCISE CATEGORIES Exercises for individuals with arthritis can be further divided into three general categories, each with specific and pertinent goals. FLEXIBILITY EXERCISES (RANGE OF MOTION AND STRETCHING) These exercises help maintain normal joint movement, relieve stiffness, and improve flexibility. Each joint in the body has a specific range of motion. People with arthritis should try to move each joint through its complete pain-free range of motion daily to prevent stiffness, loss of motion and deformity. Stretching exercises performed as a warm-up or cool-down will lengthen and lubricate muscles and connective tissue, as well as maintain or improve flexibility. MUSCULAR STRENGTH AND ENDURANCE EXERCISES These exercises help maintain or increase the strength and endurance of muscles. Weak muscles that quickly fatigue add to joint and biomechanical problems. Isotonic and isometric exercises are commonly used in exercise programs for people with arthritis. Isotonic exercises require muscle contractions as the joint is moved against gravity or AEA Arthritis Foundation Program Leader: A Training Guide for Exercise & Aquatic Programming 21
