Übungen bei Psoriasis-Arthritis — enthesitis-bewusst, Gewichtsverlust krankheits-modifizierend, Hautpflege

CASPAR classification + GRAPPA 2021 + 2024 EULAR PsA management framework. Psoriatic arthritis is heterogeneous: peripheral arthritis, axial involvement (~20-50% of patients), enthesitis (classically Achilles + plantar insertion), dactylitis (the 'sausage digit'), psoriatic skin and nails, uveitis (~7%), and IBD overlap. Cardiovascular risk is elevated ~1.4× general population. Pinto 2018 + Roger-Silva 2018 RCTs established that structured aerobic + resistance training reduces disease activity + functional status without triggering flares. Critically, Klingberg 2019 PSOWEIGHT trial showed that 5-10% BMI reduction meaningfully improves PASI + ACR responses — making weight loss disease-modifying in PsA, not just cosmetic. Low-impact aerobic + range-of-motion + posture work; AVOID heavy plyometric overload during active enthesitis (insertional tendons need calm graded loading). Skin protection during exercise: psoriatic plaques chafe under tight clothing + heat triggers flares — choose moisture-wicking loose fits + post-exercise gentle cleanse + emollients.

Volya's catalogue carries the foundation moves: supported-glute-bridge for posterior chain (helpful for sacroiliitis-axial component), wall-push-up for scaled upper-body strength, scapular-retraction for posture, cat-cow for spinal mobility, supine-knee-to-chest for low-back release, diaphragmatic-breathing for parasympathetic regulation + chest-wall mobility, standing-march for managed cardio, sit-to-stand for functional + bone-loading, ankle-pump for circulation + DVT prevention if axial involvement limits walking during flare. The AI coach also knows the nutrition side — anti-inflammatory Mediterranean backbone (Klingberg 2019 + Caso 2020: Mediterranean reduces PsA disease activity + BMI + CV risk concurrently), weight loss reduces disease activity (5-10% BMI), omega-3 1-3 g/day EPA+DHA (Kristensen 2018 RCT reduces fatigue + tender joints), vitamin D often low (target 40-60 ng/mL), AVOID ultra-processed + high-sodium + SSBs (drive metabolic syndrome + flares per patient report), AVOID alcohol excess (methotrexate hepatotoxicity + worsens psoriasis), protein 1.2-1.4 g/kg/day during active disease + erosive periods, IBD-overlap consider low-FODMAP trial + GI referral. CRITICAL: National Psoriasis Foundation (NPF) + GRAPPA + rheumatology + dermatology + ophthalmology if uveitis + GI if IBD overlap + cardiology + dietitian familiar with cardiometabolic + autoimmune. AVOID nightshades elimination popular online — weak evidence + nutrient gap risk. This is NEVER a replacement for rheumatology + dermatology care.