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Osteoarthritis and Exercise

Evidence for Exercise with OA

Physically active people are healthier and live longer than those who are not. This is also true for those with arthritis. However, arthritis is the primary cause for inactivity in adults. Inactivity produces and progresses the signs and symptoms associated with arthritis, namely muscle weakness and atrophy, decreased flexibility and cardiovascular fitness, osteoporosis, depression and lowered pain threshold.

In the past it was believed that rest would benefit inflamed joints and promote healing. However, recent studies have shown that people with OA of the knee can tolerate weight-bearing exercise such as walking. In fact, studies show great benefits in exercise for people with OA.

A randomized control trial of 439 community-dwelling adults with knee OA compared groups that had 18 months of aerobic walking with programs of resistance exercise and of health education, for their effects on self-reported disability, physical performance, aerobic capacity, strength, radiographic signs and pain, with a control group. Both exercise groups improved in physical performance, knee flexion strength, and decreased pain compared to the education group. An analysis of outcomes by percentage of sessions performed showed significant improvements in disability, pain and walk scores associated with increasing compliance.⁵

A systematic review of randomized clinical trials examined the effectiveness of exercise therapy in patients with OA of the hip or knee. Trials were selected if treatment had been randomly allocated and if pain, self-reported disability, observed disability, or patient's global assessment of effect had been used as outcome measures. The review showed evidence of beneficial effects of exercise therapy in patients with OA of the hip or knee.⁷

A convenience sample from a rheumatology out-patient department had 111 participants with knee OA. Quadriceps sensorimotor function and disability in 60 patients was compared before and after an exercise regime with a control group (n=37) who did not exercise. The results substantiate the association between quadriceps sensorimotor dysfunction and disability, emphasizing the importance of quadriceps exercise in the management of knee OA.²

Exercise may be the most effective treatment for OA available. Exercise is proven to improve general health and mood, reduce disability and fatigue, and to favorably modify risk factors in disease progression. It is important to understand the different types of exercise and the difference between exercising for health and exercising for fitness. An appropriate exercise program should be as healthy, effective, and comfortable as possible.