For patients with knee osteoarthritis, there are mostly symptoms such as pain, swelling, and muscle weakness that worsen during certain activities, and some people will be reluctant to exercise because of this or fear that exercise will aggravate the damage to the knee joint. Some studies have shown that physical labor and obesity can significantly increase the incidence of osteoarthritis in the knee, but daily and recreational activities do not osteoarthritis condition. Appropriate exercise therapy can help with osteoarthritis recovery. Exercise therapy under the guidance of a professional rehabilitation physician, in conjunction with other treatments, has many benefits for patients with osteoarthritis of the knee. Several studies have confirmed that exercise therapy can provide the impetus for the movement of nutrients into and out of joint cartilage, and that mechanical stimulation can regulate the expression of inflammatory mediators and cytokines. Exercise therapy can break the vicious cycle of recurrent osteoarthritis attacks. Increases periarticular muscle strength, increases joint stability, improves ligament toughness, and increases joint flexibility. Promote the circulation of joint fluid and improve the nutritional status of joints. Exercise thickens the bone cortex, and the osteophyte undergoes corresponding structural changes to adapt to muscle pulling and pressure loads, making the bone stronger and preventing and treating osteoporosis. Aerobic exercise can effectively oxidize body fat to lower body mass index, thus avoiding obesity to aggravate osteoarthritis. A previous survey conducted in Huangpu District, Shanghai, showed that elderly patients with knee osteoarthritis had their body mass index reduced from 25,0±2,9 before exercise to 24,4±2,9 through 1 year of Baduanjin exercise. exercise therapy can also effectively improve patients’ proprioception and significantly increase their standing time on one leg with eyes closed. It can improve the integration of the nervous system into the motor system, improve coordination of movement and prevent falls. Patients with knee osteoarthritis should not be afraid of exercise. If rest is substituted for exercise, it will only disuse the joint and aggravate the condition. As long as the correct type of exercise is chosen, it can be beneficial to the recovery of knee osteoarthritis. How to develop an exercise prescription for knee osteoarthritis? 1. Principles of exercise for patients with knee osteoarthritis Before developing an exercise prescription, the principles of exercise must first be clarified. For patients with knee osteoarthritis, exercise should be safe first, and the patient’s health status should be evaluated in detail before formulating an exercise prescription. For people with chronic underlying diseases it is especially important to prevent risks such as falls and hypoglycemia, and it is recommended to exercise with a partner. Following the principle of individualization, it is necessary to choose the appropriate exercise according to the patient’s physical condition. Exercise programs do not have to be forced, as long as there is no damage to the joints. Gradual and orderly, the amount of exercise should not be forced, so as not to cause injury. Perseverance, exercise can only be effective if it is adhered to for a period of time. You should not be greedy for quick results. Generally adhere to the exercise at least two weeks before the effect. Do not interrupt after the effect, or intermittent. If the pain symptoms caused by exercise can not be relieved, or fatigue, swelling, weakness and other symptoms after 1 to 2 hours of exercise, it means that the exercise is too much, and the amount of exercise needs to be adjusted, which is the patient’s self-test indicator. 2. Recommended Exercise Prescription The American Geriatrics Society has specifically developed an exercise prescription for knee osteoarthritis that can be used as a reference for patients with knee osteoarthritis. How can this exercise prescription be interpreted? First, joint mobility training increases joint range of motion, stretches contracted muscles, and increases flexibility. It is often used in the warm-up phase or during the transition from plyometrics to aerobics. Note: The speed of joint extension should be slow and the force should be light to avoid pain. Static stretching time is generally mastered in 10 to 30 seconds. Next, plyometric training, which must be individualized, follows the 2-hour principle to avoid muscle fatigue. The resistance provided must be less than the maximum muscle force, and isometric muscle training is best applied when joint pain exists. Isometric contraction plyometric training, is a static contraction of the muscle that does not cause joint movement. The muscle is made to move against the resistance without joint movement, maintaining only its fixed position. It increases the static muscle strength and endurance and provides the initial impetus for the movement of the joints. All key muscle groups can be trained. Special attention should be paid to not holding your breath during training, but breathing naturally. You can have a natural conversation with your partner who is exercising together. Rest for 20 seconds between contractions. Gradually increase from single joint angles, to multi-joint angles. Contractions longer than 10 seconds will raise blood pressure. Isotonic contraction muscle strength training, is power training, such as lifting dumbbells, push-ups, etc. It can provide dynamic muscle strength increase to provide power to complete normal joint activities. In addition, there is isometric training, which is a revolutionary advancement in plyometric training, but requires special equipment. Plyometric training culminates in closed chain training that includes multiple muscle groups and multiple joints with repetition of activities of daily living, such as walking up stairs. Plyometric training must be done with safety in mind. Third, aerobic exercise training increases aerobic capacity, improves body structure, and lowers blood pressure. The choice of exercise should be based on the older person’s disease, activity, joint stability and interest. Aerobic exercise training should be varied and should involve as many muscles and joints as possible to avoid boredom. Generally aerobic exercise training should have an adaptation phase of 2~3 months, after which the amount of exercise can be increased by 2 or 5%/week. 3. Follow the exercise training pyramid It is recommended that for patients with knee osteoarthritis, the most done is basic daily activities, such as housework and walking. Do more aerobic and recreational activities, do moderate muscle strength training and joint mobility training, and sit less. 4, exercise precautions exercise must be safe, when the joints appear red, swollen, hot, painful pause. Do not do exercise that will lead to increased pain, and the amount of exercise should not be too large. Find like-minded sports partners can make exercise more interesting and prevent accidents. In addition to exercise, it is also necessary to develop the right diet, proper rest, healthy exercise and happy mood habits.