Is Exercise Good For Osteoarthritis?

ALL people with Osteoarthritis (OA) should be advised to exercise as a core treatment, irrespective of age, comorbidity, pain severity or disability.

A Cochrane Review¹⁷ shows that:

• High-quality evidence suggests that land-based therapeutic exercise provides benefit in terms of reduced knee pain and improved quality of life and moderate-quality evidence of improved physical function among people with knee osteoarthritis.
• Any type of exercise programme that is performed regularly and is closely monitored can improve pain, physical function and quality of life related to knee OA in the short term.
• The magnitude of immediate treatment effects of exercise on pain and physical function increases with the number of contact occasions with the healthcare professional.
• Mediating effects of exercise dosage and disease severity on the effectiveness of exercise could not be determined because of large variability in reported data.

Benefits of Exercise For Osteoarthritis (OA)

Exercise has similar-sized (moderate) pain-relieving effects in OA as analgesics¹⁸. People with knee OA often don’t know this! Sharing this information with your patient can serve as a motivator to exercise. It is also important to educate patients that pain-relief with exercise won’t be immediate but takes some time (weeks) – patience is required!

Most people with Osteoarthritis (OA) don’t meet recommended levels of daily physical activity:¹⁹

• Only a small proportion of people with knee OA meet physical activity guidelines
• People with knee OA average only 50 mins per week of moderate-to-vigorous physical activity when measured in bouts of 10 mins or more- YET current guidelines for adults and older adults recommend at least 150 min per week
• People with OA average 7753 daily steps- YET a popular health recommendation is for adults to achieve 10,000 daily steps

Daily walking is important to prevent future functional decline in knee OA²⁰:

• More walking is associated with less risk of functional limitation over 2 years in people with knee OA.
• Walking >6,000 steps/day may protect against developing functional limitation in people with or at risk of knee OA.

People with knee OA spend around two-thirds of their day in sedentary activities: strategies to reduce sedentary activity are important.

• Replacing 60 mins/day of sedentary time with 60 mins/day of light activity is associated with a 17% reduced risk for incident slow gait speed 2 years later²¹
• Approx. 5 mins/day of moderate to vigorous physical activity = equivalent benefits of 60 mins/day of light activity

_{(Source: Osteoarthritis Action Alliance, 2019)}