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Exercise Therapy

Exercise Therapy

Obesity is one of the risk factors for developing osteoarthritis, which may present with pain in the joints. Exercise has, in recent years, been promoted as one of the ways of managing pain in joints (Li and Argáez). It strengthens the muscles surrounding the joints and reduces pain by improving control of the painful joint during exercise. Reducing the amount of weight exerted on joints is also recommended as it can reduce disease progression and severity of symptoms. Training on land is, therefore, challenging for overweight patients. Non-weight-bearing exercises such as cycling, water walking, and swimming can help achieve aerobic training for such individuals (Li and Argáez).

Both water aerobics and cycling are beneficial exercises for this client as they are low-impact exercises. They both support joints and allow for contraction and strengthening of the muscles around the joints. Notably, stationary cycling supports body weight, and repetitive cycling motions strengthen the calf muscles as well as the quadriceps (Kutzner et al.). Similarly, aquatic exercises are beneficial to overweight individuals as they lower the amount of stress exerted on joints. Accordingly, this is achieved by underwater buoyancy, which reduces the weight placed on the joint (Kutzner et al.). The buoyancy of water supports the body weight and, therefore, reduces the impact of the client’s weight on the joints. This also helps to reduce the intensity of pain experienced by the client. The viscosity of water provides a safety margin by allowing the client to stop activity at the joint if they feel pain (Song and Oh).

Underwater exercises also help with the balanced development of agonist and antagonist muscles, thereby contributing to isokinetic muscle contraction. It is, therefore, appropriate for physically weak patients. Aquatic exercises can relax muscles, relieve stress, and reduce muscle stiffness because of the temperature and pressure of the water. These help to facilitate movement. In addition, walking in water is an essential component of aquatic exercise as it helps with gait reeducation. Walking in water occurs at speeds 30% slower than on land (Song and Oh). Patients who walk at the same speed in water experience higher levels of exertion. Therefore, the client should walk in water the same way they would on the ground. Also, the patient should walk sideways in all directions and backward to tone all muscle groups. Shifting weight between limbs is possible and can be done easily under deep water to relieve pain. This maneuver is not possible for land exercises. Other forms of exercise, such as running on land and walking, would not be appropriate as they would result in more weight being exerted on the joints. Consequently, this would discourage the client from finishing the program.

A five-day program would entail alternating between water walking and cycling on land and on water.

Rehabilitation component/exercises
Day  1 ·          Warm-up exercise by walking slowly in water and moving slowly from right to left for five minutes.

·         Practice deep water walking by immersing the body at depths ranging from the waist to the chest. This should be done for 30 to 45 minutes.

·         Perform standing exercises while standing upright and hands on the side and then lifting the knees slowly off the ground.

·         Cool down for five minutes after getting out of the water.

·         Perform stretching exercises for 5 minutes.

Day 2 ·         Warm-up exercise by walking slow in water and moving slowly from right to left for five minutes.

·         Practice deep water walking by immersing the body at depths ranging from the waist to the chest. This should be done for 30 to 45 minutes.

·         Lift the leg and move it toward the wall. Repeat this exercise for the other leg. Try and move the leg around in all directions while holding the wall for balance. This should be performed at least five times or for 30 minutes.

·         Cool down for five minutes after getting out of the water.

·         Perform stretching exercises for five minutes.

Day 3 ·         Stationary cycling on land. The patient should be seated with the legs lifted. The exercise should be done slowly, and the resistance of the cycle should be increased gradually.

·         Cycling in water. Activity should be performed in a supine position with a floating device used for support.

·         Stand with the feet apart for five minutes.

·         Press the hips behind while reaching the hands in front.

Day 4 ·         Warm-up exercise by walking slow in water and moving slowly from right to left for five minutes.

·         Rock the hips for flexibility for three minutes. Press the hips back and rock from back to front.

·         Rotate the hips in all directions. Follow this by sliding the hips from side to side for three minutes. Perform this in three sets.

·         Practice deep water walking by immersing the body at depths ranging from the waist to the chest. This should be done for 30 to 45 minutes.

·         Cool down for five minutes after getting out of the water.

·         Perform stretching exercises for five minutes.

Day 5 ·         Practice deep water walking by immersing the body at depths ranging from the waist to the chest. This should be done for 30 to 45 minutes.

·         Cool down for five minutes after getting out of the water.

·         Perform stretching exercises for five minutes.

Works Cited

Kutzner et al. “Does Aquatic Exercise Reduce Hip and Knee Joint Loading? In Vivo Load Measurements with Instrumented Implants”. PLOS ONE, vol 12, no. 3, 2017, p. e0171972. Public Library of Science (Plos), https://doi.org/10.1371/journal.pone.0171972. Accessed 18 May 2022.

Song, Ji-Ah, and Jae Woo Oh. “Effects of Aquatic Exercises for Patients with Osteoarthritis: Systematic Review with Meta-Analysis”. Healthcare, vol 10, no. 3, 2022, p. 560. MDPI AG, https://doi.org/10.3390/healthcare10030560. Accessed 18 May 2022.

Li, Yan, and Charlene Argáez. Body Weight Modification Interventions for Chronic Non-Cancer Pain: A Review of Clinical Effectiveness. Canadian Agency for Drugs and Technologies in Health.

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Question 


CASE STUDY: An internist refers a 275-lb patient with joint pain and gait abnormalities to you. Would walking in water or cycling be the most efficient exercise? Give a sample 5-day program for each type of exercise. State your reasons for not using other forms of exercise. Please take a look at the condition and physical limitations you are dealing with in this patient. After considering these limitations, as well as the goal of training for this individual, you are to design two (2) different programs: one(1) aquatics-training-based program and one(1) cycling-based program.

Exercise Therapy

Exercise Therapy

Exercise Therapy Edition 3
Knopf, Karls chapters 15-16

The Merck Manuals is a free online medical library written for non-medical professionals. Explains disorders, who is likely to get them, their symptoms, how they’re diagnosed, how they might be prevented, and how they can be treated; also provides information about prognosis. Use this website to search for topics discussed in this week’s lecture.
http://www.merckmanuals.com/home/index.html (Links to an external site.)

Healthline.com (Links to an external site.) – offers physician-reviewed content, health tools, and videos from more than 20 leading medical reference publishers and media partners, including A.D.A.M., GALE Cengage Learning, Gold Standard, NBC Universal, StayWell, Harvard Health Publications, Reed Elsevier and more.

A brief overview of the benefits of aquatic exercise –
http://www.cdc.gov/healthywater/swimming/health_benefits_water_exercise.html (Links to an external site.)

Exercise listing of different aquatic-based movements –
http://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/aquatic-exercise/sls-20076730 (Links to an external site.)

Safe wheelchair transfer techniques –
https://www.karmanhealthcare.com/wheelchair-transfer-techniques/ (Links to an external site.)

Exercise principles for individuals with ambulatory conditions and/or limited mobility –

How to Exercise with Limited Mobility

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