The ongoing nature of most rheumatic diseases makes it important
to maintain and, when possible, improve joint mobility and
overall functional status. The individualized exercise program is
crucial to movement. Table 54-4 summarizes the exercises appropriate
for patients with rheumatic diseases. Appropriate programs
of exercise have been shown to decrease pain and improve
function. A mild analgesic may be suggested prior to exercise for
a patient starting a program of exercise. Acute or prolonged pain
associated with exercise should be reported to a health care
provider for evaluation (Minor & Westby, 2001).
The major challenge for the patient and the health care provider
is the need to adjust all aspects of treatment according to the
activity of the disease. Especially for the patient with an active
diffuse connective tissue disease, such as RA or systemic lupus
erythematosus (SLE), activity levels may vary from day to day and
even within the day itself.