Osteoarthritis is estimated to affect 250 million people worldwide leading to high rates of global pain and disability. These rates are expected to raise as our population of baby boomers continues to age into their golden years. Unfortunately, many with osteoarthritis will become less active or sedentary because of their symptoms and in turn are at risk for many chronic diseases including diabetes and heart disease. Physical inactivity has also been shown to be one of the risk factors for mental health diagnoses including dementia. Exercise remains one of the most powerful conservative treatments for over 20 chronic conditions including arthritis.
A new clinical commentary highlights the importance of exercise in the treatment of patients with hip and knee arthritis (Skou et al. JOSPT. 2018). Authors report on the evidence from over 50 and 10 randomized controlled trials on the effects of exercise for knee and hip arthritis, respectively. Articles report exercise therapy in this patient population is as effective as anti inflammatory medications for these conditions. Interestingly, the effects of exercise, aerobic or strengthening, are not dependent on a patient’s severity of arthritis or clinical presentation. Thus all patients can benefit from a Physical Therapy exercise program tailored to their specific needs and clinical condition.
Authors recommend beginning with supervised exercise sessions prescribed by a Physical Therapist. This allows the Physical Therapist to design these programs based on the patient’s clinical presentation and make adjustments as needed for an optimal therapeutic response. In general, experts recommend 30-60 minute exercise sessions, twice per week, focused on both aerobic and strength training of major muscle groups. This dosage is thought to reduce the chronic low grade inflammation associated with arthritis as well as many chronic diseases including diabetes and heart disease. Conversely, physical inactivity creates a cycle of chronic inflammation and contributes to chronic disease progression. In addition to its’ anti inflammatory effects, exercise also impacts many of the associated risk factors for chronic diseases including high blood pressure, cholesterol, insulin resistance, body mass index, and body composition changes.