الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
Osteoarthritis is the most common joint disorder among population. The most commonly affected is the weight- bearing knee joint.Most reports suggests development of osteoarthritis due to weakness of quadriceps muscle. Pain and disability secondary to knee osteoarthritis among elderly are commonly affecting the daily activities of living . Because of the evidence data pointing to muscle weakness as a determinant of functional ability in knee OA, and the ability of strength training programs to improve these variables, individuals with knee OA should be counseled to begin an exercise program of strengthening exercise. Isotonic and closed chain exercises seem likely to be more beneficial, with isometric exercises reserved for patients who find these painful. The goal should be to progress to a combination of open and closed chain isotonic exercises. Closed chain exercises such as stair stepping and squatting can be done safely after proper instruction. Aerobic exercise also appears to have convincing, albeit modest, benefits. Variable changes affecting skeletal muscle structure seconderaly to strength and endurance training in the form of ; hypertrophy of muscle fibers: greater in type II fibers , hyperplasia (possibly) of muscle fibers, remodeling of type IIB to type IIA (thus, more fatigue resistance); with no change in type I to type II distribution (i.e., no conversion) , decrease or no change in capillary bed density (because of increase in number of myofilaments per fiber) decreased mitochondrial density and volume(thus, reduced oxidative capacity). identifying efficient and effective exercise protocols, strategies to improve compliance, the long-term effects of exercise on the joint, and the cost-effectiveness of such programs. Progressive resistive exercise improved muscle strength and self-reported measures of pain and physical function in over 50–75% of cases ; 50–100% of the studies reported a significant improvement in all except walking time due to its highly performance-based physical function as it increase muscle strength and stamina. The effects of resistance training exercise on health-related osteoarthiritic patient quality of life and depression are yet to be confirmed. More research needs to be conducted to establish dose-response relationships and the effect of resistance training on long-term disability, knee OA pathology, and progression. Beneficial short-term effects of aquatic exercise were found in adults with osteoarthritis of the hip or knee. Although the programme may not offer pain relief or self-reported improvements in physical functioning, results suggest that aquatic exercise does not worsen the joint condition or result in injury. Nurses engaging in disease management and health promotion for these patients should consider recommending or implementing aquatic classes for patients.