OA and Exercise (Essay Sample)

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Systematic reviews of randomized controlled trials (RCTs) indicate that exercise therapy reduces pain and patient-reported disability in patients with (OA), but to date, the optimal exercise regimen has not been identified (1,2). The effects of exercise programs in clinical trials are likely to vary, since the interventions differ substantially in type of exercise (aerobic, strengthening, etc.), intensity of exercise, duration of intervention, and number of sessions per week. Furthermore, the patients included are often heterogeneous in age, sex, body mass index (BMI), radiographic severity of OA, and degree of malalignment (2).

Aerobic exercise, such as walking or cycling, is a popular choice for the management of lower limb OA. Aerobic exercise is an effective nonpharmacologic treatment with medium effect sizes for improvements in pain and function. When considering the impact of weight-bearing activity, other studies showed that exercise in the standing or weight-bearing positions such as walking for participants with knee osteoarthritis might aggravate symptoms such as pain, swelling, and inflammation if the knee joint is overloaded.31

While strengthening exercise is recommended, there is no evidence to suggest that the specific type of strengthening exercise significantly influences outcome. Similar benefits have been found with isotonic (through range), isometric (without movement), and isokinetic (performed on specific machines) strengthening exercise [8] as well as with strengthening exercise performed in weight-bearing or non-weight-bearing positions [21,22]. In addition, strengthening programs for knee OA have either focused on the quadriceps muscle or included strengthening of other lower limb muscles in addition to the quadriceps. A systematic review revealed small effect sizes for quadriceps strengthening for both pain and physical function. By contrast, moderate effect sizes were found for muscle strengthening that included several lower limb muscles [7].

Aquatic exercise appears to have similar effects on pain compared to land-based exercise in people with OA. Aquatic exercise is an option for patients and may be particularly useful in those who are overweight/obese or who have severe joint-related symptoms. The buoyancy of the water can assist in improving the range of motion and pain with reduced loading to joints. Aquatic exercise can also improve aerobic capacity, if the exercise specifically targets the aerobic system with patients working at 50% or greater of their heart rate reserve.

A meta-analysis of 48 randomized control trials with a total of more than 4,000 patients showed that exercise therapy programs focusing on a single type of exercise are more efficacious in reducing pain and patient-reported disability than those mixing several types of exercise with different goals within the same session; For best results, the program should be supervised, carried out 3 times weekly, and comprise at least 12 sessions. Such programs have similar effects regardless of patient characteristics, including radiographic severity of OA.

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Several methodical reviews of randomized controlled trials (RCTs) point out that exercise therapy actually decreases pain as well as patient-reported disability in patients who have OA. Up to now however, the optimal exercise treatment is yet to be known (1, 2). The results of exercise programs in medical trials are often different primarily because the interventions vary considerably in the kind of exercise, for instance strengthening or aerobic; length of the intervention; intensity of the exercise; as well as the number of sessions for each week. In addition, the patients who are included are mostly varied with regard to radiographic severity of OA, sex, degree of malalignment, body mass index (BMI), and age (2).
Aerobic exercise, for instance bicycle riding or walking, is a choice that is actually well-liked and common in managing lower limb OA. Aerobic exercise is in fact an effectual non-pharmacologic treatment and has medium effect sizes for improvements in both function and pain. With regard to the effect of weight-bearing activity, some researchers have reported that exercise in the weight-bearing position or standing position for instance walking for participants who have knee osteoarthritis may exacerbate symptoms like inflammation, swelling, and pain if the knee joint becomes overloaded (31).
Although strengthening exercise is advised, evidence to indicate that the specific sort of strengthening exercise considerably influences result is lacking. The same benefits have been found with isometric (without movement); isotonic (through range); and isokinetic strengthening exercise and with strengthening exercise carried out in non-weight bearing or weight-bearing positions (21, 22). Furthermore, strengthening programs designed for knee OA have concentrated largely on quadriceps muscle or comprised strengthening of other lower limb muscles over and above the quadriceps. A methodical review showed small effect sizes for quadriceps strengthening for physical function and pain. Moderate effect sizes, on the contrary, were actually found for muscle strengthening that comprised a number of muscles in the lower limb (7).
Aquatic exercise seems to have the same effects on pain compared with land-based exercise in individuals who have OA. It is worth mentioning that aquatic exercise is, in essence, an alternative for patients with OA and it could be of use especially in those obese/overweight patients, or patients with joint-related symptoms that are severe. The water’s buoyancy can hel...

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OA and Exercise (Essay Sample)

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