What types of active exercise are used to increase muscle strength and endurance in a patient with arthritis?
• Isometric training: a static muscle contraction in which the muscle length does not change and the limb does not move through any ROM. A wall squat is an example of an isometric contraction. This form of exercise is particularly good to maintain or increase muscle bulk and strength without increasing joint inflammation in a patient with active arthritis.
• Isotonic exercise: a dynamic muscle contraction with movement through an arc of motion against a fixed resistance, such as in bicep curls and standing calf raises. It should be done when joint inflammation is under control. Isotonic training begins with 1 to 2-lb weights. Before increasing weight, patients should be able to comfortably perform 12 repetitions.
• Isokinetic exercise: the rate of movement is held constant, but the force produced by the individual may vary through the arc of motion. These exercises generally involve specialty equipment, such as an exercise bike. This form of exercise is rarely used in arthritis rehabilitation.
• Aerobic and aquatic exercise programs.