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Arthritis & The Exercise Gap

By ANAHAD O’CONNOR

Exercise can help ease joint pain and stiffness for arthritis sufferers. But despite urgings from health officials and plenty of science documenting its benefits, many men and women with osteoarthritis do not engage in any meaningful physical activity in a typical week, according to new research.

The findings directly contradict what many arthritis patients themselves report when asked about their exercise habits. Studies in the past have generally shown that 30 to 40 percent of people with arthritis say they get at least 150 minutes of moderate-intensity exercise each week, or about 20 minutes a day, the minimum amount that the federal government recommends for all adults.

But when researchers at the Northwestern University Feinberg School of Medicine used special devices to track the activity levels of more than 1,000 people with knee osteoarthritis, they were surprised to find that many were in fact couch potatoes. Only 13 percent of men and 8 percent of women met the federal guidelines for activity.

Exercise is specifically recommended for osteoarthritis patients because it can reduce pain, ease joint stiffness, increase strength and improve mobility, said Dorothy Dunlop, an associate professor of medicine at Northwestern and an author of the study.

“Physical activity is a positive intervention for people with joint disease,” she said. “We certainly applaud the 10 percent of people who met the target, but we also recognize that many adults with arthritis are not meeting the target, and for that group the advice is to be as physically active as possible, even if they accomplish less than the recommended level.”

As part of the study, published in the current issue of the journal Arthritis & Rheumatism, Dr. Dunlop and her colleagues asked more than 1,000 people with osteoarthritis to wear accelerometers, small pedometerlike devices that measured their levels of movement and activity. The participants ranged in age from 49 to 84 and wore the devices for a week.

The finding that was most alarming, Dr. Dunlop said, was that almost half the people in the study met the Department of Health and Human Services definition for “inactive,” meaning they did not participate in any moderate exercise lasting at least 10 minutes at any point over the course of the week.

“Frequently they’re very surprised,” she said. “They thought that they were doing vigorous activity and working hard, but the monitor measures no vigorous activity.”

Some arthritis sufferers steer clear of physical activity because of pain and stiffness. Others find their energy sapped by conditions like diabetes or heart disease, Dr. Dunlop said.

But there is also a widespread perception that people with arthritis need to rest their joints, a myth that the Centers for Disease Control and Prevention has worked hard to dispel. The American College of Rheumatology has also made a point of encouraging people with arthritis to spend more time going on brisk walks or taking part in water aerobics and other activities that can benefit their joints.

Still, Dr. Dunlop said she believes doctors who treat patients with arthritis are the ones who can have the greatest effect. “There is evidence that if a person is encouraged by their physician to be active, it’s a stronger message than if they’re encouraged by a friend or a family member,” she said. “So it would be wonderful if one of the first messengers was their own physician.”

Hermes O. Koop M.D., 599 Ninth St. North #307 Naples, Florida 34102 website : hermeskoopmd.com