Table 1

Level and grade of evidence for physical activity recommendations for patients with arthritis

RECOMMENDATIONLEVEL*GRADE
Patients with advanced forms of disease or radiologic evidence of severe joint damage should participate in non–weight-bearing activities to maintain or improve mobility, strength, and cardiovascular function. These patients should not participate in very-high-intensity exercises such as those involving jumping or high-load-bearing activitiesIIA
Those individuals with recently diagnosed arthritic disease or those experiencing acute flare-up of their disease should be prescribed physical activity that limits exacerbations of disease activity, such as light to moderate pool-based exercise§ or light cycle ergometer activityIIIB
Patients with stable, well-controlled disease and no progressive joint damage may participate in a variety of physical activities including weight-bearing and non–weight-bearing activities to maintain or improve mobility, strength, and cardiovascular functionIIA
  • * Level I evidence includes randomized controlled trials; level II evidence includes randomized controlled trials with important limitations or observational trials with overwhelming evidence; level III evidence includes observational trials; and level IV evidence includes anecdotal evidence or expert opinion.

  • Grade A recommendations are strong; grade B recommendations are intermediate; and grade C recommendations are weak.

  • Stage III or IV arthritis.

  • § Water aerobics.