EXERCISE IN THE TREATMENT OF OSTEOARTHRITIS

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• 作者：Marian A. Minor ; PT ; PhD^*
• 刊名：Rheumatic Disease Clinics of North America
• 出版年：1999
• 出版时间：1 May 1999
• 年：1999
• 卷：25
• 期：2
• 页码：397-415
• 全文大小：1240 K

文摘

Exercise may be the most effective, malleable, and inexpensive modality available to achieve optimal outcomes for people with osteothritis (OA). Exercise, in a variety of forms, has proved to be integral in (1) achieving therapeutic goals, (2) improving general health and reducing secondary disability and (3) modifying possible risk factors in disease progression. The potential benefits of appropriate exercise in the treatment of OA span the process of potential disablement in this disease . Despite the evidence supporting this accessible and economic modality, most rheumatologic recommendations for management of OA provide detailed discussions of pharmacologic and surgical interventions, while mentioning in only general terms ¡°physical therapy and exercise?or ¡°rehabilitation?as additional treatment options. In order to explicate the use and effectiveness of exercise in OA, this article presents the rationale for use of the three major categories of exercise¡ªrange of motion (ROM)/flexibility, strength, and aerobic/cardiovascular exercise¡ªin the treatment of OA.

People with OA receive exercise recommendations from health care providers and exercise professionals in clinical and community-based settings. Physical and occupational therapists prescribe therapeutic exercise to reduce pain, impairments, and improve function. Health/fitness instructors, and now the Public Health Service recommend programs of exercise and physical activity to promote health and physical fitness. The goals, benefits, and contents of the exercise programs from both sources often overlap; distinctions blur as certified fitness professionals engage in exercise testing and prescription, and therapists move into community settings.

Many people with OA can succeed in community exercise programs with guidance from a knowledgeable and experienced instructor on site. For others, professional consultation with a knowledgeable health professional can be a crucial first step in the development and adoption of a safe and effective exercise habit. Undoubtedly, the best interests of the person with OA are served when the exercise experience arises from the melding of knowledge of the disease, rehabilitation, kinesiology, exercise physiology, and exercise behavior in an accessible, enjoyable, and affordable setting. Such collaboration provides a supportive environment in which the person with OA can experience success and learn to maintain self-directed regular exercise and appropriate physical activity.

The goals of this article are to provide information about the purpose, effectiveness, and content of a variety of exercise modalities that benefit people with OA, and to persuade the reader of the value of exercise recommendations, monitoring, and follow-up to promote health and reduce the impact of OA. Because hip and knee OA are the major disabling diagnoses and have been the focus of OA exercise research, the majority of current evidence speaks to these two conditions; however, information about exercise in spinal arthritis, when available, will also be presented.