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At present, many exercises have therapeutic effects on osteoarthritis, such as aerobic exercise, strength training, swimming, neuromuscular exercise, proprioceptive training, and balance training.

Patients with mild osteoarthritis can start with any exercise but severe Osteoarthritis should start with low impact activities such as water activities like swimming and static cycling.

1. Swimming: while in water, effect of body weight is less on joints hence exercising becomes easier. Once the joints open up and become flexible then one can graduate to land exercises as they are more effective in achieving long term pain control and improved activities.

2. Static cycling: is another form of low impact exercises and helps in regaining flexibility and strength of joints.

3. Floor Exercises: Aerobic exercise is the most widely used in Osteo-arthritis patients. Low-intensity aerobic exercise had a better therapeutic effect in patients with severe Osteo-arthritis , while high-intensity aerobic exercise had a better therapeutic effect in patients with mild Osteo-arthritis. It encompasses various exercises for every joint and muscle and can be titrated as per patient requirement and targeted outcome.

4. Strength training is the most effective in improving muscle strength, and neuromuscular training was the best training method to relieve Osteo-arthritis pain They can improve the physical function of Osteo-arthritis patients and have a significant impact on the psychological status of Osteo-arthritis patients.

5. New intervention methods such as virtual reality and sports games have been gradually used to improve people’s physical and psychological conditions.

Although many types of exercise can be used to prevent or treat Osteo-arthritis, our most recommended method is to formulate a unique exercise prescription for each patient with Osteo-arthritis based on the FITT (Frequency, Intensity, Time, and Type) principle i.e. Exercise frequency, Exercise intensity, Exercise time & Exercise type.

Precautions: Pain relief can be obtained only after 8–11 weeks of exercise therapy. Continuous exercise for more than 12 weeks is generally recommended to relieve decreased muscle strength and muscle atrophy associated with Osteo-arthritis.

Patients with higher obesity are more suitable for aquatic exercise. For patients with upper limb Osteo-arthritis, emphasis should be placed on improving the affected joints’ range of motion and flexibility. For patients with lower limb Osteo-arthritis, emphasis should be placed on improving patients’ muscle strength and body stability. Therefore, we should formulate individualized exercise prescriptions according to the degree of lesion and needs of Osteo-arthritis patients.

(Dr Dhananjay Gupta, Senior Director Orthopedics, Fortis Vasant Kunj)