Exercise Prescription for Arthritis
and Rheumatological Problems
Dr. Christopher Tong
Christopher Tong –
different roles
orthopaedic surgery / sports medicine
Proud father of two
Triathlete
Current Appointments
• Orthopaedic Surgeon in Private Practice
• Hong Kong Sports Institute
– Honorary Sports Medicine Consultant
• CUHK
– Honorary Clinical Assistant Professor
– Orthopaedic Department
– Family Medicine Department
What exercises should I
prescribe to patient’s with joint
pain ?
Arthritis / joint conditions
• Neck pain
• Back pain
• Osteoarthritis of knees
• Osteoarthritis of hips (more common in
caucasion population)
What problems do patients with
joint pain experience ?
• Stiffness of joints
• Weakness of muscles
• Psychological problems, depression etc.
– Dependent
– Can’t exercise
Why is exercise beneficial ?
• Improve range of motion of joints
• Increase muscle strength
• Psychological well being
• Cardiorespiratory benefits
• Lower blood pressure
• Weight control
• Avoid unnecessary medication
Traditional exercises prescribed
• Swimming
• Cycling
• Walking
• Hydroexercise
• Principle of gradual progression
American Geriatric Society on
Exercise and Osteoarthritis
American Geriatric Society Panel
on Exercise and Osteoarthritis
• Initial evaluation
• Assessment
• Exercise prescription
• Re-evaluation
• Monitoring in 4-6 months
• Progressive increase in exercise dose
Sequence of events when doing
exercise
• Warm up
• Conditioning
– Aerobic activity
– Strength training
– Stretching
• Cool down
Stretching
Resistance / strength
training
Exercise Prescription
• Aerobic exercise
– 20-30 minutes per day, 3-4 times per week
• Flexibility
– Initial: hold 5-15 seconds
– Subsequent: 3-5 stretches, hold 20-30s
• Strength-training exercise
– Isometric
• Hold < 6 s, 20 s rest period daily
– Isotonic
• 6-15 repetitions, 2-3 / week
Precautions in exercise
prescription
• Osteoporosis
– Engage in low-impact weight bearing activities
and resistance training
• Lumbar spondylosis
– Avoid extreme twisting motions o