Before beginning the exercise session, ask the patients to describe any pain or discomfort felt in their joints. Next, for the upper extremity warmup, instruct the patient to reach a range of motion with no discomfort for each joint movement. For the lower extremity, guide the patient to perform warmup exercises in a standing position with both feet grounded on a stable surface.
Then instruct the patient to reach a non-painful movement. Speed through the range of motion for each joint while sitting on the chair in the setup phase. Instruct the patient to perform functional movement patterns with more than two joints per segment.
Initiate the work phase by setting a comfortable walking speed for the patient on the treadmill. After five minutes, adjust the speed while concurrently measuring the heart rate. With a pulse oximeter, increase the speed until reaching a heart rate zone between 55 and 75%of the maximum heart rate.
After 10 minutes, assess the patient using a perceived effort rating scale for the final five minutes. Lower the treadmill speed to a comfortable pace for the patient. Next, perform upper extremity mobility resistance exercises while handling a wooden stick with both hands.
After teaching the patient combined exercises encompassing the range of motion for more than two joints. Instruct the patient to place one end of the resistance band on the floor and step on it with their foot. Then perform elbow flexion against the band's resistance.
For lower extremity exercises, have the patient sit in a stable chair with 90 degree hip and knee flexion. Then perform hip flexions for each leg up to 20 to 30 degrees above the starting position. Then ask the patient to perform a slight hip flection above 10 degrees from the base position, followed by a hip abduction.
Lastly, lead the patient to return at a slow tempo to the base position. Next, make a soccer goal by placing two chairs approximately 1.3 meters apart. Direct the patient to kick a 30 centimeter plastic at a three meter spot in front of the soccer goal.
Finally, gently perform a global stretch for cooling without putting stress on the joints. Participants who did not undertake the exercise program had a similar disease activity, but a slightly higher average age and BMI. No changes were made to any patient's pharmacological treatment during the intervention period.
Before the exercise, all patients were classified as cachexia and had an average resistance of 630 and a reactance of 46. After exercise, the patients were reclassified as normal with an average resistance of 577 and reactants of 57. The patients who did not participate in the exercise program showed a shift in BIVA classification toward cachexia.
Over six months, implementing the dynamic exercise program resulted in a decrease in resistance per height and an increase in reactance per height. No statistically significant changes were observed in the group that did not undergo the exercise program.
