Knee arthrosis is a highly prevalent disease that greatly affects the quality of life of patients due to accompanying symptoms. It has the highest incidence of associated chronic non-communicable diseases, and lifestyle changes with changed behavioral patterns of physical activity are crucial for achieving long-term treatment results. Due to associated chronic non-communicable diseases, the complexity of treating patients and the lack of guidelines for the physical activity of people with several associated chronic non-communicable diseases at the same time, a multimodal approach is needed. We need to understand the impact of each disease on the clinical course of knee arthrosis and the patient's response to prescribed exercise due to associated medical conditions. For this purpose, the introductory part presents the effects of physical activity on aging and chronic non-communicable diseases, the main characteristics of knee arthrosis and the most common associated chronic non-communicable diseases, as well as the importance of physical activity with prescribed exercise guidelines for each disease.
The fundamental goals of our research study were to determine whether a structured exercise program improves the quality of life, pain, physical function, body composition and performance of selected tests of strength, enduarance, mobility and balance in patients with knee arthrosis who were not regularly physically active before the start of the study, and they had health restrictions that affected the course of the program at the time of the measurements and exercise program. The study included two patients. One was a 61-year-old female with associated non-communicable diseases obesity and hypertension and a 60-year-old male with associated non-communicable diseases obesity and type 2 diabetes. Before and after the exercise intervention, body composition measurements, strength, endurance, mobility, and balance tests were performed, and both patients were examined by an orthopedist. A patient with type 2 diabetes was also examined by a specialist in internal medicine. The exercise program lasted twelve weeks and included morning exercises, exercises for strength, mobility, balance, coordination, and endurance training with gradual load and performance progression. Results showed that participants improved muscle strength of knee extensors and flexors, muscle strength of hip abductors and adductors, mobility of the knee, quantitative and qualitatitve performance of tests such as chair stand test, timed up and go test, forty-meter fast-paced walk test, stair climb test, and six-minute walk test. They did not improve the outcome of all stability indices on the Biodex Balance Systems device. With the results of the questionnaire, it was found that there was an improvement in quality of life, physical function in activities of daily life, sports and recreation, and a reduction of arthrosis symptoms and pain.
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