A new study published on April 1, 2019, in the American Journal of Preventive Medicine suggested that baby steps toward that goal could make a big difference when it comes to managing osteoarthritis. Researchers discovered that brisk walking for just one hour a week can make a huge impact when it comes to maintaining independence and postponing disability for people with arthritis pain.
A Reasonable Walking Recommendation, Even if You Have OA
“This is less than 10 minutes a day for people to maintain their independence. It’s very doable,” said Dorothy Dunlop, PhD, lead author of the study and professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago. “We were very excited to see that even this small amount of activity had a very meaningful health benefit because we felt that this would be very encouraging to people with arthritis and a motivation start moving more.”
Maintaining Mobility Will Motivate People Living With OA
These results should provide people with OA more motivation to get or stay physically active, says Abigail Gilbert, MD, a rheumatologist at the Thurston Arthritis Research Center at the University of North Carolina in Chapel Hill, who was not involved in this research. “There have been several studies that have shown that physical activity decreases the chance of developing disability. This study examined just how much you need to do to decrease your risk of developing disability,” says Dr. Gilbert.
Osteoarthritis Is Common, Especially in the Knee
According to the Arthritis Foundation, more than 30 million people in the United States have osteoarthritis (OA), making it the most common form of arthritis. The lifetime risk of developing symptomatic knee osteoarthritis is 45 percent. In healthy joints cartilage covers the end of each bone, which provides a smooth surface for joint motion and also acts as a cushion between the bones. When a person has OA, the cartilage deteriorates and causes pain, swelling, and mobility issues.
10 Minutes a Day Can Keep Disability Away
To find out how much activity was necessary to help people remain free of disability, study investigators looked at four years of data from more than 1,500 adults in the National Osteoarthritis Initiative from Baltimore, Pittsburgh, Columbus, Ohio, and Pawtucket, Rhode Island. Participants ranged in age from 49 to 83 years old; 56 percent were female, and 38 percent had a body mass index (BMI) of 30 or higher. At the beginning of the study all participants experienced pain, aching, or stiffness in lower extremity joints from osteoarthritis but were free of disability.
Research Tracked People With OA Over Several Years
Physical activity was monitored using accelerometers. Disability-free status was assessed at the start of the study, at the two-year mark, and at the end of the four years. Mobility was measured with a timed walking test, and activities of daily living (ADL) disability-free status was assessed from the report of no limitations in performing basic ADL tasks: walking across a room, dressing, bathing, eating, using the toilet, and bed transfer. The study found that the participants who engaged in an hour of weekly moderate-to-vigorous physical activity were able to maintain their ability to perform ADLs. Those people reduced their risk of ADL disability by almost 45 percent. The weekly hour of exercise also reduced the risk mobility disability (walking too slowly to safely cross a street, or less than 1 meter per second) by 85 percent. These findings are encouraging, but not surprising, says Ankit Bansal, MD, a fellow in orthopedic surgery at Johns Hopkins Medicine in Baltimore, who was not involved with this research. “Based on the patients I meet who come in with arthritic pain, the ones who move around the most are the ones who are the most pain-free,” says Dr. Bansal. This is a cohort study, and as such the results apply to a large population of people, but individuals will not necessarily have the same benefits, says Gilbert. A cohort study follows people who have a common characteristic (in this case, OA), but there is no control group or intervention.
Why Walking Works for Osteoarthritis
“Walking and other physical activity have many benefits for people with arthritis,” says Dr. Dunlop. “Part of the reason physical activity is beneficial is because in arthritis people need strong muscles to compensate in their everyday activities for joints that are often compromised by the disease process. Physical activity helps improve muscle strength, stamina, and balance; specific to arthritis, it can help to control the pain associated with arthritis,” she says. Many people with arthritis can eventually need a replacement surgery, like knee-replacement, says Bansal. That tends to happen when the joints get stiff — stiffness is directly correlated to pain, he says. “People who are moving the most and who are the most limber tend to keep their joints calm and therefore more pain-free,” he says.
A Stepping Stone to Higher Activity Goals
The current government exercise recommendation is for people to do at least two and a half hours of moderate activity each week, and that includes people living with arthritis, says Dunlop. Exercise can help prevent many chronic diseases, like heart disease, type 2 diabetes, and depression. “Many people with arthritis are inactive — not only do they not meet guidelines, they do almost no moderate activity,” says Dunlop. It’s her hope that showing people that achieving this more moderate goal could not only reap real benefits, it could motivate them to strive for more activity and the whole array of health benefits that exercise can confer. “This could be a first stepping stone goal,” says Dunlop. “It should not replace the recommended amount because there are many benefits to exercise that go beyond what we looked at in this study, but it’s an important start,” she says.
‘Not Moving Is Not the Answer’
People with OA should definitely talk to their individual physician about barriers to engaging in physical activity in order to uncover causes and find possible solutions, says Dunlop. “Physical therapy or other approaches could be helpful,” she says. “In general, we encourage people to weave moderate activity into their lifestyle. If you like to walk, find ways to walk more. If you usually drive to your mailbox, try walking instead. If you are a commuter and take public transportation, consider getting off the bus or train a few blocks early and walking those few extra blocks. Weaving more physical activity into your everyday life can make a real difference and help you maintain your independence,” says Dunlop. “One thing that people tend to feel is that if they have a lot of pain they shouldn’t ‘aggravate it’ and therefore they shouldn’t move a whole lot,” says Bansal. “I think that tends to be the opposite of what we generally tell people, and that would go against what this study shows. Not moving is not the answer,” he says.
