Therapeutic exercise in the management of rheumatic diseases.

In spite of the wide use of therapeutic exercise in the management of musculoskeletal diseases such as chronic arthritis, there are few controlled studies that establish its effectiveness. Only active contraction can increase muscle strength. Exercises in the horizontal plane or of limbs supported by the buoyancy of water can be carried out with relative ease by people with weak muscles or painful joints. The benefits of exercise programs can be classified as improving general fitness, increasing joint mobility and reconditioning. Whether the large amount of money currently being spent on exercise programs is truly cost-effective is an important question relating to health policy that requires an answer.