Which is MOST appropriate for juvenile rheumatoid arthritis with painful swelling in both knees?

Which is MOST appropriate for juvenile rheumatoid arthritis with painful swelling in both knees?

• A. Resistive exercises
• B. Stretching to prevent contractures
• C. Gentle active exercises
• D. Walking program

Answer: (C)

When joints are actively swollen and painful, the goal is to move enough to maintain range of motion and muscle function without putting extra stress on the inflamed joints. Gentle active exercises fit this need because the patient actively moves the knees within a comfortable, pain-free range, promoting circulation and preventing stiffness while minimizing joint loading. This approach supports function and progression as symptoms allow, without the higher stress that resistive exercises would impose or the potential irritation that aggressive stretching or weight-bearing activities could cause during a flare. Passive or aggressive stretching can provoke pain and tissue irritation when the joint is inflamed, and a walking program, while beneficial later, may exacerbate swelling and pain if started during an active flare. So the most appropriate choice is gentle active movements that respect pain limits and inflammation.

When joints are actively swollen and painful, the goal is to move enough to maintain range of motion and muscle function without putting extra stress on the inflamed joints. Gentle active exercises fit this need because the patient actively moves the knees within a comfortable, pain-free range, promoting circulation and preventing stiffness while minimizing joint loading. This approach supports function and progression as symptoms allow, without the higher stress that resistive exercises would impose or the potential irritation that aggressive stretching or weight-bearing activities could cause during a flare. Passive or aggressive stretching can provoke pain and tissue irritation when the joint is inflamed, and a walking program, while beneficial later, may exacerbate swelling and pain if started during an active flare. So the most appropriate choice is gentle active movements that respect pain limits and inflammation.