A patient with rheumatoid arthritis is referred to a physical therapist for exercise prescription. Which consideration is MOST important when prescribing exercise for this patient?

• A. Include low-load, prolonged stretching activities
• B. Give a low priority to pain as an indicator of exercise tolerance
• C. Modify exercise according to the phase of the disease process
• D. Increase the duration of exercise while decreasing the frequency

Answer: (C)

Tailoring exercise to how active the rheumatoid arthritis is at the moment is essential because joint tolerance to stress changes with disease activity. When inflammation is high, joints are tender, swollen, and more vulnerable, so the focus is on gentle movements, energy conservation, and avoiding heavy or repetitive loading. As the disease moves toward a subacute phase or remission, tissues tolerate more loading, so you can progressively increase strength, endurance, and range-of-motion work while still protecting joints with proper technique and gradual progression. This phase-based approach protects joints from flare-provoking stress and optimizes functional gains.