People With OA More Sedentary Than Previously Believed

Study finds 40 percent of men and 56 percent of women with knee osteoarthritis are completely inactive.
By Jennifer Davis
It’s long been known that many arthritis patients tend to be sedentary, but a new report shows just how pervasive the problem is. The study, published in the August issue of Arthritis & Rheumatism, found that fewer than 1 in 7 men and 1 in 12 women with knee osteoarthritis, or OA, were physically active enough to meet federal guidelines. The U.S. Department of Health and Human Services recommends 150 minutes of moderate-intensity, low-impact activity per week.
In fact, 57 percent of women and 40 percent of men were classified as “inactive” – that is, they did not engage in moderate-to-vigorous activity for 10 minutes or more at any time during the course of a week.
This level of inactivity is higher than that found in earlier studies, mainly because previous studies relied on self-reporting as opposed to objective measurements.
“I think everyone knew people with arthritis were not particularly active. This proves that … it’s a major, major issue,” says study co-author Rowland W. Chang, MD, MPH, a professor of preventive medicine and rheumatology at Northwestern University’s Feinberg School of Medicine in Chicago. “The lack of physical activity is the major health issue for persons with arthritis to confront.”
Using a machine called an accelerometer to register all motion during waking hours, the researchers measured the activity of 1,111 knee OA patients between the ages of 49 and 84. Although this study didn’t compare self-reported physical activity levels with actual accelerometer data, Dr. Chang notes that most people overestimated their activity level by at least two-fold.
Dr. Chang says the study defined “moderate intensity” as activity that raises your heart rate, making you a little sweaty but still allowing you to carry on a conversation.
Physical activity is very important for people with OA: It has been shown to help reduce pain and symptoms of depression, fight fatigue, increase function and physical performance, and prevent or delay disability in knee OA, as well as improve general health and reduce the risk of several chronic diseases. An earlier study by some of the same researchers found that OA patients benefit from some physical activity even if they don’t reach the recommended 150 minutes per week, and the more they exercise, the greater the potential benefit.
“You could argue it’s an important challenge for our entire society, but for people with arthritis, it’s a particularly daunting challenge,” says Dr. Chang. “It’s a wake-up call for people with arthritis and physicians who care for them.”
Patience White, MD, vice president, public health for the Arthritis Foundation and professor of medicine and pediatrics at the George Washington School of Medicine and Health Sciences in Washington, D.C., says these numbers are sobering.
“Americans aren’t hearing the message, but people with arthritis aren’t getting it either,” says Dr. White. “I think people feel [physical activity] will make their arthritis worse. Somehow the pain makes them think something isn’t right. It’s counterintuitive to say, ‘Actually, it will make me feel better.’”
Dr. White says awareness campaigns help get the message out that physical activity is important. But she says that, as a rheumatologist, she also believes physicians have to spend time with patients to find out what individual barriers keep them from being physically active.
“I think you have to [deliver the message] on all levels, and people need to hear it five times in five different ways. So the more people who are delivering this message, the better,” Dr. White adds.
She recommends patients ask themselves why they aren’t active, and then to look for small ways throughout the day to change that, such as:
• Parking at the far end of the parking lot so your walk is a little farther.
• Scheduling a walk into your day – say, in the evening after dinner or in the morning before breakfast when you’re less busy.
• Making exercise a social event with family or friends who will hold you accountable.
• Walking around the block during your lunch break.
• Finding a fun activity, such as swimming, biking or playing an easy game of tennis.
“Figure out how you can do 10 minutes. If you are going to get the mail and you have to walk down the driveway, go up and down three times and then pick up the mail,” Dr. White suggests.
Regular physical activity can help relieve the sleep problems that dog many people with arthritis. It also can lead to weight loss, and losing just 1 pound eases 4 pounds of pressure from your knees. “People with arthritis say it’s remarkable – even just losing 5 pounds can make pain much better,” Dr. White says.

On August 19, 2011, posted in: Articles, Featured Stories by