Physical activity in men and women with arthritis National Health Interview Survey, 2002.

BACKGROUND Regular physical activity in persons with arthritis has been shown to decrease pain, improve function, and delay disability. This study estimates the national prevalence of leisure-time physical activity and identifies factors associated with physical inactivity in adults with arthritis. METHODS Data from the 2002 National Health Interview Survey were analyzed in 2004-2005 to estimate the proportion of adults with arthritis meeting four physical activity recommendations put forward in Healthy People 2010 and one arthritis-specific recommendation established by a national expert panel in arthritis and physical activity. Multivariate logistic regression was used to evaluate the association between inactivity and sociodemographic factors, body mass index, functional limitations, social limitations, need for special equipment, frequent anxiety/depression, affected joint location, joint pain, physical activity counseling, and access to a fitness facility. RESULTS Adults with arthritis were significantly less likely than adults without arthritis to engage in recommended levels of moderate or vigorous physical activity, and 37% of adults with arthritis were inactive. In both men and women with arthritis, inactivity was associated with older age, lower education, and having functional limitations; having access to a fitness facility was inversely associated with inactivity. Among women, inactivity was also associated with being Hispanic, non-Hispanic black, having frequent anxiety/depression or social limitations, needing special equipment, and not receiving physical activity counseling. Among men, inactivity was also associated with severe joint pain. CONCLUSIONS Although physical activity is a recommended therapy for people with arthritis, levels among adults with arthritis are insufficient, and those with arthritis have worse activity profiles than their peers without arthritis. Efforts to promote physical activity should include expanding access to evidence-based interventions and recreational facilities/programs. The importance of physical activity counseling and associated pain management measures by healthcare providers should be emphasized.

[1]  G. Komatireddy,et al.  Efficacy of low load resistive muscle training in patients with rheumatoid arthritis functional class II and III. , 1997, The Journal of rheumatology.

[2]  M. Pratt,et al.  Inactivity-Associated medical costs among US adults with arthritis. , 2001, Arthritis and rheumatism.

[3]  H. Gür,et al.  Concentric versus combined concentric-eccentric isokinetic training: effects on functional capacity and symptoms in patients with osteoarthrosis of the knee. , 2002, Archives of physical medicine and rehabilitation.

[4]  Thomas J. Schnitzer,et al.  Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update , 2000 .

[5]  L. Verbrugge,et al.  Gender and health: an update on hypotheses and evidence. , 1985, Journal of health and social behavior.

[6]  D. Dunlop,et al.  Risk factors for functional decline in older adults with arthritis. , 2005, Arthritis and rheumatism.

[7]  M. Heo,et al.  Are US adults with arthritis meeting public health recommendations for physical activity? , 2004, Arthritis and rheumatism.

[8]  S le Cessie,et al.  Effect of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial , 2000, Annals of the rheumatic diseases.

[9]  R. Simms,et al.  Guidelines for the Management of Rheumatoid Arthritis , 2002 .

[10]  Task Force on Community Preventive Services Recommendations to increase physical activity in communities. , 2002, American journal of preventive medicine.

[11]  A. Manley Physical Activity And Health: A Report Of The Surgeon General , 2004 .

[12]  Timothy M. Morgan,et al.  Effects of physical activity counseling in primary care: the Activity Counseling Trial: a randomized controlled trial. , 2001, JAMA.

[13]  Massey Jt,et al.  Design and estimation for the National Health Interview Survey 1985-94. , 1989 .

[14]  T. Housh,et al.  Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint. , 1996, Nursing research.

[15]  Michael E. Miller,et al.  Exercise and depressive symptoms: a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. , 2002, The journals of gerontology. Series B, Psychological sciences and social sciences.

[16]  K. Chakravarty,et al.  Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee--the MOVE consensus. , 2005, Rheumatology.

[17]  D. Felson,et al.  The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial. , 2001, The Journal of rheumatology.

[18]  J. Kelsoe,et al.  Gender differences in outpatient research subjects with affective disorders: a comparison of descriptive variables. , 1995, The Journal of clinical psychiatry.

[19]  C. Ekdahl,et al.  Dynamic versus static training in patients with rheumatoid arthritis. , 1990, Scandinavian journal of rheumatology.

[20]  S. Mcconnell,et al.  Exercise for osteoarthritis of the hip or knee (Protocol) , 2000 .

[21]  Chris Dickens,et al.  Depression in Rheumatoid Arthritis: A Systematic Review of the Literature With Meta-Analysis , 2002, Psychosomatic medicine.

[22]  G. Newsome Guidelines for the management of rheumatoid arthritis: 2002 update. , 2002, Journal of the American Academy of Nurse Practitioners.

[23]  B. Kramer,et al.  Effects of exercise on fatigue, aerobic fitness, and disease activity measures in persons with rheumatoid arthritis. , 1997, Research in nursing & health.

[24]  S. Hahn,et al.  Gender, quality of life, and mental disorders in primary care: results from the PRIME-MD 1000 study. , 1996, The American journal of medicine.

[25]  C. Helmick,et al.  Validity and reliability of self-reported arthritis: Georgia senior centers, 2000-2001. , 2005, American journal of preventive medicine.

[26]  K. Muir,et al.  Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial , 2002, BMJ : British Medical Journal.

[27]  J. Gurwitz,et al.  Validation of a surveillance case definition for arthritis. , 2005, The Journal of rheumatology.

[28]  J E Hewett,et al.  Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis. , 1989, Arthritis and rheumatism.

[29]  Y. el-Miedany,et al.  Is anxiety a more common disorder than depression in rheumatoid arthritis? , 2002, Joint, bone, spine : revue du rhumatisme.

[30]  R. Manske,et al.  The Effects of Aquatic and Traditional Exercise Programs on Persons With Knee Osteoarthritis , 2001, Journal of strength and conditioning research.

[31]  W. Applegate,et al.  A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). , 1997, JAMA.

[32]  N. Beck,et al.  Depression in rheumatoid arthritis. , 1988, The Journal of rheumatology.

[33]  C. Bouchard,et al.  Physical Activity and Health , 2006 .

[34]  H. Kraemer,et al.  Group- vs home-based exercise training in healthy older men and women. A community-based clinical trial. , 1991, JAMA.

[35]  B. Penninx,et al.  Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis. , 2005, Arthritis and rheumatism.

[36]  J. Kehayias,et al.  The effect of progressive resistance training in rheumatoid arthritis. Increased strength without changes in energy balance or body composition. , 1996, Arthritis and rheumatism.

[37]  J P Allegrante,et al.  Supervised Fitness Walking in Patients with Osteoarthritis of the Knee , 1992, Annals of Internal Medicine.

[38]  R. Craik,et al.  The effects of high-intensity and low-intensity cycle ergometry in older adults with knee osteoarthritis. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[39]  C. Helmick,et al.  Health related quality of life among adults reporting arthritis: analysis of data from the Behavioral Risk Factor Surveillance System, US, 1996-99. , 2003, The Journal of rheumatology.

[40]  A. Stewart,et al.  The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. , 1989, JAMA.

[41]  M. Heo,et al.  Changes in the Prevalence of US Adults With Arthritis Who Meet Physical Activity Recommendations, 2001–2003 , 2005, Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases.

[42]  S. Blair,et al.  Influence of physical activity-related joint stress on the risk of self-reported hip/knee osteoarthritis: a new method to quantify physical activity. , 2003, Preventive medicine.

[43]  M Fransen,et al.  Physical therapy is effective for patients with osteoarthritis of the knee: a randomized controlled clinical trial. , 2001, The Journal of rheumatology.

[44]  L. Trupin,et al.  Medical care expenditures and earnings losses of persons with arthritis and other rheumatic conditions in the United States in 1997: total and incremental estimates. , 2004, Arthritis and rheumatism.

[45]  David T Felson,et al.  Clinical practice. Osteoarthritis of the knee. , 2006, The New England journal of medicine.

[46]  R A Oostendorp,et al.  Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review of randomized clinical trials. , 1999, Arthritis and rheumatism.

[47]  Richard L Prince,et al.  Recreational Physical Activity Levels in Healthy Older Women: The Importance of Fear of Falling , 2002, Journal of the American Geriatrics Society.

[48]  B. Dijkmans,et al.  Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results of a randomised clinical trial. , 1996, Annals of the rheumatic diseases.

[49]  R. Petrella,et al.  Home based exercise therapy for older patients with knee osteoarthritis: a randomized clinical trial. , 2000, The Journal of rheumatology.

[50]  R. Yood,et al.  Guidelines for the management of rheumatoid arthritis: 2002 Update. , 2002, Arthritis and rheumatism.

[51]  T. Vlieland,et al.  Safety of exercise in patients with rheumatoid arthritis , 2005 .

[52]  C. Helmick,et al.  Intervention Programs for Arthritis and Other Rheumatic Diseases , 2003, Health education & behavior : the official publication of the Society for Public Health Education.

[53]  M. Hopman-Rock,et al.  The effects of a health educational and exercise program for older adults with osteoarthritis for the hip or knee. , 2000, The Journal of rheumatology.

[54]  M. Nelson,et al.  The benefits of strength training for older adults. , 2003, American journal of preventive medicine.

[55]  C. Helmick,et al.  Physical activity levels among the general US adult population and in adults with and without arthritis. , 2003, Arthritis and rheumatism.

[56]  M. Sevick,et al.  Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. , 2004, Arthritis and rheumatism.

[57]  D. D'cruz,et al.  Fatigue in systemic lupus erythematosus: a randomized controlled trial of exercise. , 2003, Rheumatology.

[58]  M. Westby,et al.  A health professional's guide to exercise prescription for people with arthritis: a review of aerobic fitness activities. , 2001, Arthritis and rheumatism.

[59]  J. Williamson,et al.  Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. , 2001, Archives of internal medicine.

[60]  Michael Doherty,et al.  Effectiveness of home exercise on pain and disability from osteoarthritis of the knee: a randomised controlled trial , 1999, Annals of the rheumatic diseases.

[61]  M. Hegel,et al.  Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial. , 2003, JAMA.

[62]  J. Newsom,et al.  Characteristics of physically inactive older adults with arthritis: results of a population-based study. , 2003, Preventive medicine.

[63]  C. Bombardier,et al.  Exercise for treating fibromyalgia syndrome. , 2007, The Cochrane database of systematic reviews.

[64]  G. Mcclearn,et al.  Gender and health: a study of older unlike-sex twins. , 2002, The journals of gerontology. Series B, Psychological sciences and social sciences.

[65]  C Finch,et al.  Current injury or disability as a barrier to being more physically active. , 2001, Medicine and science in sports and exercise.

[66]  D. Bassett,et al.  Assessment of physical activity by telephone interview versus objective monitoring. , 2003, Medicine and science in sports and exercise.

[67]  H. Schumacher,et al.  Osteoarthritis of the knee: isokinetic quadriceps exercise versus an educational intervention. , 1999, Archives of physical medicine and rehabilitation.

[68]  H. Bliddal,et al.  The effects of a physical training program on patients with osteoarthritis of the knees. , 1998, Archives of physical medicine and rehabilitation.

[69]  T. Prohaska,et al.  Public health and aging , 1997 .

[70]  P. Hannonen,et al.  A randomized two-year study of the effects of dynamic strength training on muscle strength, disease activity, functional capacity, and bone mineral density in early rheumatoid arthritis. , 2001, Arthritis and rheumatism.