Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

Clinical trial: The Study of Neuromuscular Exercise Therapy and Patients Self-management Program in Knee Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

        -

        1.Clinical diagnosis of knee osteoarthritis, Diagnostic criteria is based on the Chinese
        medical association's 2007 diagnosis and treatment guidelines for osteoarthritis:

          1. Repeated knee joint pain within 1 month;

          2. X-ray(weight-bearing or not)shows narrowed joint space,sclerosis and (or) cystic
             degeneration of subchondral bone, osteophytes of the joints;

          3. The joint fluid (at least twice) is clear and viscous, WBC<2000个/ml;

          4. Age of patients ≥40 yrs;

          5. Morning stiffness≤3 min;

          6. Bone friction in the activity; Note：Combine clinical feature, laboratory and X-ray
             examination,when the patients meet(1)+(2) or (1)+(3)+(5)+(6) or (1)+(4)+(5)+(6)，they
             can be diagnosis as knee osteoarthritis.

        2.VAS≥4分; 3.No surgical treatment is planned within 6 months;

        Exclusion Criteria:

          1. Other types of arthritis, such us RA(rheumatoid arthritis)

          2. Severe deformity of knee joint;

          3. Over obesity patients（BMI>35）;

          4. Other comorbidities that would severely affect somatic function, such as: cerebral
             infarction, lumbar disease that meets surgical indications, lower extremity
             angiopathy;

          5. Decompensated cardiac dysfunction;

          6. Severe cardiovascular and cerebrovascular diseases, or the patient is too weak for any
             kinds of exercise;

          7. Lack of compliance;
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 50 Years old.


Eligibility (NLI label): Contradiction