OSTEOARTHRITIS obic capacity.

Muscle atrophy often occurs in the quadri- ceps muscle in patients with a painful knee. This in turn will fail to support the joint making the condition worse. Controlled rehabilitation exercises have been shown to increase quadriceps strength and decrease disability without exacerbating pain in patients with OA knee.

It is important to maintain a full range of movement of the knee as this will help to preserve joint function. Exercise undertak- en in the swimming pool is becoming increasingly popular as the water can offer sufficient resistance to ease the stress on the afflicted joint.

Many patients with OA knee complain of fatigue. Because of pain their mobility is reduced and they become less active. Graded aerobic activity such as swimming and walking can improve fitness. This form of exercise will also encourage weight loss and have cardiovascular bene- fits.

Strength, flexibility and aerobic exercises will not only relieve symptoms of OA knee but also provide protection against wors- ening of the condition. The benefits of exercise only occur if the activity is undertaken on a regular basis. A success- ful programme needs to be accessible - for

example exercises at home may be more practical, affordable and enjoyable than at the local leisure centre. Practitioners need to regularly reinforce the importance and benefits of exercise.

Contacts and Resources ● The Arthritis Research Campaign

(ARC), St Mary’s Gate, Chesterfield, Derbyshire, S41 7TD

● Arthritis Care, 18 Stephenson Way, London, NW1 2HD. Patient helpline 12pm-4pm (Mon-Fri) 0800 289170.

Further reading ● Hochberg M.C et al. Guidelines

for the medical management of osteoarthritis. Arthritis and Rheumatism 1995;(Nov).

● Hurley M.V et al. Improvements in quadriceps function and disability of patients with knee osteoarthritis fol- lowing a clinically practicable exer- cise regime. Br.J of Rheumatology 1998;37:1181-1187

● Osteoarthritis. Prescriber Journal 1998 Vol.38 No.4

● ABC Rheumatology. BMJ Publishing Group