Regular exercise should become part of the routine treatment for older people suffering from osteoarthritis of the knee, doctors are recommending. Aerobics or resistance exercises can reduce disability and pain, while improving physical performance.

The American College of Rheumatology had recommended that exercises be one of the mainstays of treatment, but doctors have been unclear about the type of exercise to recommend, or its duration.

Researchers from the Fitness Arthritis and Seniors Trial (FAST) tested the recommendation out on 365 sufferers who completed the 18 month trial. Those in the aerobic team walked in their neighbourhood as part of a programme that consisted of 10 minutes of warm up, 40 minutes of walking and then a final cool down period of 10 minutes, three times a week.

The second programme of resistance exercises followed a similar pattern but involved nine exercises to improve overall muscle fitness.

The researchers said that "modest" improvements were reported, although those who did more of the exercises reported greater benefits (JAMA, 1997; 277: 25-31).

Moderate exercise can also help people sleep better, researchers have found. Healthy, but sedentary, older people who had sleeping problems found they had a better night's sleep if they did some exercise.

The programme consisted of 30 minutes of low impact aerobics or brisk walking four times a week, report researchers from Stanford University (JAMA, 1997; 277: 32-7).