Author Topic: In osteoarthritis, some exercise better than none  (Read 60 times)

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Offline agate

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In osteoarthritis, some exercise better than none
« on: January 12, 2017, 04:25:46 pm »
People with MS are just as vulnerable to osteoarthritis as the rest of the population, and it's a very common disorder as we grow older.  Researchers are finding out what they already strongly suspected--that keeping our joints moving through regular exercise is one sure way to cut down on the effects of OA.

From MedPage Today, January 6, 2017:

In OA, Some Exercise Better than None

Osteoarthritis patients had improved function with 45 minutes of activity per week

by Wayne Kuznar
Contributing Writer

Meeting the total of 45 minutes per week of moderate to vigorous activity significantly increased the relative risk of improved or high function compared with less active adults, according to data from more than 1,000 individuals who participated in the Osteoarthritis Initiative (OAI).

Writing online in Arthritis Care & Research, investigators led by Dorothy Dunlop, PhD, of Northwestern University in Chicago, observed that the evidence-based threshold of 45 minutes per week is less stringent than the federal physical activity threshold of at least 150 minutes per week of moderate to vigorous activity.
"For adults with lower limb joint symptoms who often do little or no moderate activity, a less demanding physical activity target tied to function may be a valuable intermediate benchmark towards meeting the current physical activity guideline" -- and this lower threshold may be a more feasible activity goal for such patients, Dunlop and colleagues wrote.

Most adults do not meet the minimum threshold of 150 minutes a week of moderate-intensity physical activity or 75 minutes of vigorous activity, which led the authors to investigate alternate activity metrics, they explained.

The study population consisted of 1,647 participants (56% female, ages 49 to 83) in the OAI, which is a multicenter prospective study investigating risk factors and biomarkers for the progression or onset of knee OA. A total of 93% of participants reported knee symptoms and 60% had hip symptoms, while 54% had both. Physical activity was monitored using a uniaxial accelerometer and patient logs recording the time spent in water and cycling activities.

Participants were placed in one of five quintiles of gait speed and function at baseline. Improved or high function was based on maintenance of gait speed and physical function in the highest of five quintiles at baseline, or moving up to higher quintiles over time.

Other candidate metrics examined were being sedentary or non-sedentary and participating in light activity. Using area under the curve (AUC), each metric was compared with having moderate-vigorous activity of at least 150 minutes per week in bouts lasting at least 10 minutes (reference metric) as a predictor of high or improved function. The reference metric served as the current physical activity guideline.

At the 2-year follow-up, 34% of participants had improved/high gait speed and 38% had improved or high patient-reported physical function.

The calculated AUC indicated that all metrics were better than a "random coin flip" at predicting improved/high function measures. However, only moderate-vigorous total activity of more than 45 minutes had a greater AUC than the reference metric to predict both improved/high gait speed (AUC 0.65 versus 0.60, difference 0.05, 95% CI 0.03-0.07) and patient-reported physical function (AUC 0.59 versus 0.57, difference 0.02, 95% CI 0.001-0.03).

The optimal threshold to predict improved/high objective gait speed physical function was 45 moderate-vigorous total activity minutes per week. The optimal minimum threshold to predict improved/high patient-reported physical function was 47 moderate-vigorous total minutes per week.

More than 45 minutes a week of moderate-vigorous activity better discriminated subsequent improved/high gait speed than the current guideline of 150 minutes a week or more, as demonstrated by the stronger relative risk (1.8 versus 1.4, respectively). Similarly, more than 47 minutes a week of moderate-vigorous activity had a higher relative risk than the current guideline (1.4 versus 1.3) to predict improved or high patient-reported physical function.

Sensitivity analyses indicated that the moderate-vigorous total thresholds were stable independent of sex, body mass index, the presence of knee osteoarthritis, and age.

Removing the 10-minute bout constraint to moderate-vigorous activity "is a realistic step forward to increase activity levels in a symptomatic population, because those symptoms can inhibit deconditioned people (like those with joint issues) from being able to sustain 10 minutes of moderate-vigorous physical activity," Dunlop and colleagues said.

Although the 45 minutes per week threshold related to improved/high function is less stringent than the current aerobic guideline, it doesn't replace the current guideline, "which supports many other health benefits."

Regarding study limitations, the authors noted that the OAI sample is not representative, the use of other outcome definitions may have yielded different thresholds, and unreported treatments may have influenced outcomes.

The study was supported by the National Institute for Arthritis and Musculoskeletal and Skin Diseases.

Dunlop or the other authors did not report any disclosures.
MS Speaks--online for 17 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010. Glatopa (glatiramer acetate 40mg 3 times/week) since 12/16/20.


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