OA Exercise Presctiption

Question 1

OA Risk Factors

Answer 1

> 50 y.o.
Menopause
Female
High BMI
Overload
Previous injury

Question 2

Knee and Hip OA - Body Function and Structure Impairments

Answer 2

Pain, ROM, muscle weakness, coordination deficits, balance, bone enlargement, fatigue, sleep disturbance.

Question 3

Knee and Hip OA - Activity Limitations

Answer 3

ADLs: dressing, cleaning, washing, gardening.
Mobility: sitting/standing, walking, biking and other transport.

Question 4

Exercise recommendations for Knee and Hip OA

Answer 4

Weight loss for overweight or obese patients.
Balance exercises conditionally recommended.
Tai chi strongly recommended.
Yoga conditionally recommended for knee OA.

Question 5

Exercise Recommendations for Knee, Hip and Hand OA

Answer 5

Exercise strongly recommended.
Self-efficacy and self-management programs.
Education.
Should focus on patients preference and access to improve adherence and motivation.

Question 6

SMART

Answer 6

S: Start low, go slow. progress gradually.
M: modify activity (due to pain)
A: Activity joint friendly (walking, cycling, dancing).
R: Recognize safety (supervision)
T: Talk, specialist healthcare professional.

Question 7

OA Management - Strength Dosage

Answer 7

Body weight, resistance bands.
2-3xweek, 1 set of 8-12 reps at least.
Gradual Increase.
Enough weight to challenge muscle in pain free ROM.

Question 8

Aerobic Dosage

Answer 8

150 min per week, moderate. 10 min intervals per day. Low impact: walking, biking, swimming, water aerobics, dance.

Question 9

Flexibility Dosage

Answer 9

ROM: 5-10 x day, AM or PM.
Stretching: 3-5 x week, 15-30 sec.

Question 10

Hip OA Signs and Symptoms

Answer 10

Pain in groin/ant. hip.
Stiffness in morning. Worse at end of day if patient has been walking/standing for long.
Reduced PROM (IR<25°), scour test, squatting aggr., pain on active hip ext., lat. pain on active hip flex.
4/5 -> high chance of hip OA.

Question 11

Ottawa Recommendations for Hip OA

Answer 11

Patient education + strength exercises, flexibility, functional exercises at least 2x week for 10/12.

Question 12

Strength Exercises for Hip OA

Answer 12

Hip ext. flex. abd. in standing.
Hamstring curls in standing.
Bridging in supine.
Clam in side lying.
Squats, STS, heel raises with or without support.

Question 13

Knee OA - Risk Factors, Signs and Symptoms

Answer 13

Female, obese, previous ACL or meniscus injury.
Persistent knee pain, worse with activity, ease with rest. Stiffness in am, loss of knee ROM. STS, walking etc. may be painful.

Question 14

Knee OA Recommendations

Answer 14

Mix of weight and non-weight bearing exercises.
Land and water based exercises.
Weight management.
Strength training.
Self management and education.

Question 15

Knee OA Strengthening Exercises

Answer 15

Straight leg raise.
STS.
Knee ext. from sitting.

Question 16

Hand OA - Signs and Symptoms

Answer 16

Deep aching at base of thumb, stiffness, swelling, deformities. Difficulty with ADLs. Weak grip, reduced pinch strength.

Question 17

Exercise Examples for Hand OA

Answer 17

Want to increase functional strength, prevent/delay development of deformities.
Hook fist, full fist, wrist ext. flex., thumb flex., add, abd, opposition, finger abd, add, forearm supination.
Add shoulder and UL exercises.
8 week program.