Exercise and knee/hip osteoarthritis

Abstract

Introduction: Osteoarthritis (OA) is the most common joint disease, especially in the elderly population. It can affect several joints, but most commonly the knee and hip joints. While there is an abundance of studies that have investigated the effectiveness of different forms of exercise, articles that refer to general guidelines regarding the indications, contraindications, and rationale for designing an exercise program in patients with knee OA (KOA) and/or hip OA (HOA) are not as easily found.
Purpose: The aim of this review was to provide practical guidelines that can be used by exercise specialists to design a safe and effective exercise program for patients with KOA and/or HOA, taking into account the indications and contraindications of exercise for these patient groups.
Material and Methods: Relative articles were found in Google Scholar by using key terms such as “Osteoarthritis”, “Κnee Οsteoarthritis”, “Ηip Οsteoarthritis” AND “Exercise”, “Εxercise Guidelines”, “Adverse Events”.
Results: Exercise is safe and well tolerated by most people with KOA and/or HOA. Pain during exercise does not indicate worsening of the disease, as long as certain conditions are met. Various types of exercise have produced improvements in OA-specific outcomes. According to current evidence, there is no absolute recommendation either for choosing one particular type of exercise over another or for the “ideal dose” (duration, intensity, and frequency). Nevertheless, there are some indications and contraindications that should be taken into account, on a case-by-case basis. When it comes to aerobic exercise, the options vary, from low-impact to high-impact activities. Flexibility and muscle strengthening exercises in both KOA and HOA should target not only the muscles of the affected joint but all the muscles of the lower limbs, and depending on the deficits that are individually identified. Complementary elements of the training are balance and functional exercises. In any case, the goal is both to treat the symptoms caused by the disease and to improve the general physical condition.
Conclusions: The exercise is indicated for the functional management of KOA and HOA. The general guidelines here-provided can be adapted on a case-by-case basis to design and implement a safe and effective exercise program for patients with KOA and/or HOA.