The document discusses different types of physical activity and exercise that can be beneficial for patients with joint or muscle issues. It describes flexibility, resistance, and aerobic exercises. Flexibility exercises involve stretching to improve range of motion, while resistance exercises can increase strength using weights or resistance bands. Aerobic exercise includes low-impact activities to improve cardiovascular fitness. The benefits of regular physical activity for patients include reduced pain, improved muscle function and quality of life.

2.  Physical activity (PA) is defined as ‘any bodily
movement produced by skeletal muscles that
results in energy expenditure above resting
(basal) levels.
 Exercise is a subcategory of PA ‘that is planned,
structured and repetitive and [that] has, as a final
or intermediate objective, the improvement or
maintenance of one or more dimensions of
physical fitness’
Garber CE et al (2011)

4.  Active/Passive Exercise
 Isometric/Isotonics
 Kinematic chain Exercise
 Weight Bearing/Non-Weight Bearing Exercise
 Flexibility Exercise
 Strengthening Exercise
 Concentric/Eccentric exercise
 Endurance Exercise etc

5.  Flexibility exercises involve stretching
muscles and connective tissues and moving
all the joints of the body through their normal
maximal range of motion.
 It helps reduce stiffness in affected joints.
These are performed at least daily.

7. • Resistance exercise can increase strength and enhance the
capability of muscles to support the joints of the body.
• Start relatively low amount of weight to start, about 10%
of maximum, and progresses about 10% per week as
tolerated.
• Frequency should be 2 to 3 days per week with one or
more sets of 10 to 15 repetitions per exercise per session.
• Progressive resistance exercises can be performed using
machines, handheld weights (e.g., dumbbells), or
resistance bands.

8. • Aerobic or cardiovascular exercise helps improve the
overall level of fitness.
• Aerobic exercise involves non- or lowimpact
activities (e.g., walking, water aerobics, swimming,
indoor or outdoor cycling, elliptical training).
• Start with several brief (i.e., a few minutes) bouts of
aerobic exercise as tolerated to reach 20 to 30
minutes daily.
• 150 minutes of moderate-intensity activity per week
accumulated for 3 to 5 days or 75 minutes of
vigorous-intensity per week is the recommended
goal.

9. • A joint and its surrounding muscles are often
affected by surgery or the disease itself,
resulting in impaired balance and
coordination.
• Exercises to improve posture, balance, joint
position, coordination, and relaxation should
be included in a comprehensive treatment
plan.

12.  Cold packs
 Relaxation techniques
 Joint protection techniques
 Energy Conservation techniques

13. • Muscle activity relieves pain
(Tanaka R et al. Clin Rehabil 2013)
• Aerobic fitness training increases endorphin levels
• Increased muscle strength & improved neuromuscular
function improve joint stability, thereby reducing loading
• May be associated weight loss, which reduces joint loading
• ?Improves cartilage quality
(Roos EM et al. Arthritis Rheum 2005)
• Greater reduction in pain is seen after 6–8 weeks of exercise
training
(Pendleton A et al. Ann Rheum Dis 2000)

14. • Daily moderate intensity PA improves muscle
function & quality of life in pts with early RA
(Brodin N et al. Arthritis Rheum 2008)
• General PA appears to be beneficial for
maintaining joint flexibility
(van den Ende CH et al. Ann Rheum Dis 2000; Han A et al. Cochrane Database
Syst Rev 2004)

15. Regular PA improves:
• Aerobic capacity
• Muscle function
• Bone density
• Daily activity performance
• Quality of life
(Stenström CH et al. Arthritis Rheum 2003; Eversden L et al. BMC
Musculoskeletal Disorders 2007)

18. THANKYOU