Exercise, Weight Loss and Self-Care Ease Symptoms of Knee Osteoarthritis
Study Shows Lifestyle Interventions Improve Pain and Function
Keywords for this press release: knee osteoarthritis, exercise, weight loss, self-care, disability, aerobic, strength, endurance, biking, walking, analgesics, natural supplements
A recent study found that individuals with knee osteoarthritis (OA) who made lifestyle changes within 6 months of diagnosis, saw improvement in function and experienced less pain. About three-quarters of study participants started exercising, one-third initiated activity aids (knee taping, acupuncture), and one-third started taking natural medicine products. Most patients made these changes to their lifestyle on their own, without advisement from health care professionals. Details of the study appear in the April issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.
OA is the most common form of arthritis and contributes to half of all disability among older persons in North America. According to the Centers for Disease Control and Prevention (CDC), approximately 4.3 million Americans over age 60 have symptomatic knee OA. Past studies have reported that OA of the knee has significant impact on health-related quality of life (HRQOL), with 40% of those with the disease having indicated their health to be "poor" or "fair" (NHAMES III data).
In the current study, pharmacists at 27 pharmacies in the Greater Vancouver Regional District of British Columbia and in the city of Edmonton, Alberta, Canada recruited participants who had pain, aching, or discomfort in the knee during the previous year and determined eligibility using a screening questionnaire. The pharmacists identified 190 subjects with previously undiagnosed knee OA. Participants had a mean age of 63 years and were mostly white women who were either overweight or obese. Carlo Marra, Pharm.D., Ph.D., and colleagues from the University of British Columbia assessed participants for health services, product use, and HRQOL at baseline, 1,3, and 6 months following diagnosis of knee OA.
Results showed that in the first month less than 50% of subjects initiated aerobic, strength or endurance exercises such at biking or walking. By month 6 nearly 75% of participants claimed to engage in routine exercise and 80% of those who did exercise stated it helped ease their condition. Activity aids such as acupuncture, knee tape, knee braces and shoe inserts were used by 33% of participants and 75% found this to be helpful. Researchers also reported that by the end of the 6-month study period, 93% of participants had visited a primary care physician to discuss their knee OA diagnosis.
Analgesic therapy was started by 52% of study subjects, 36% began taking natural medicine supplements and 66% started therapy from one or both categories. About 50% of participants took nonsteroidal anti-inflammatory drugs (NSAIDs) and roughly 25% tried acetaminophen. For participants using natural supplements, 60% took glucosamine alone and 40% used a combination of glucosamine with chondroitin. By the end of the 6-month period, 50% of study subjects stated that the analgesics and natural supplements were beneficial in managing their knee OA.
"Most concerning was the greater number of participants who opted to first use NSAIDs prior to trying acetaminophen which is the treatment of choice for knee OA pain relief," said Dr. Marra. "The limited involvement of pharmacists in patient care was unexpected since our study introduced the pharmacist as the first point of contact for participants." A recent study by Hay et al. found that medication reviews by a pharmacist can reduce potentially dangerous NSAID use in those with knee OA.
More than 50% of study subjects stated they decided to start exercising, using activity aids, or taking analgesics on their own. Family physicians were the second most cited contact, followed by family members or friends. "It is encouraging that participants initiated exercise regimens within 6 months of their diagnosis, but surprising that so few credited a health professional with the decision to become more active," commented Dr. Marra. "This observation is an important consideration for the development of arthritis management programs that target early disease management and initiation of appropriate analgesic therapy."
Article: "After Patients Are Diagnosed With Knee Osteoarthritis, What Do They Do?" Kelly Grindrod, Carlo Marra, Lindsey Colley, Jolanda Cibere, Ross Tsuyuki, John Esdaile, Louise Gastonguay, and Jacek Kopec. Arthritis Care and Research; Published Online: March 30, 2010 (DOI: 10.1002/acr.20170); Print Issue Date: April 2010.
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