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The breakdown of bone and cartilage associated with arthritis and the consequent pain and stiffness not only discourages exercise, but also acts as a common cause of physical disability, anxiety, depression, poor quality of life and the feeling that the patient is a burden to loved ones. All of these experiences should respond positively to exercise. A recent Cochrane Library Systematic Review by Michael Hurley, PhD, professor of rehabilitation sciences at the University of London, U.K., and colleagues sought to understand the documented relationship between exercise and pain, movement ability and psychological issues. They found participation in exercise programs may slightly improve physical function, depression and pain in these patients.1
The researchers reviewed the effect of exercise on physical, emotional and mental health in individuals with chronic knee or hip joint pain from OA. They found 21 studies that addressed the topic published before March 2016. The studies included 2,372 men and women aged 45 years or older from Europe, North America, Asia and Australasia. They evaluated exercise performed in clinical settings, the home and/or recreational facilities. The authors focused on studies that evaluated patients with pain and stiffness in the knee, hip or both, and their response to exercise. The studies considered pain, movement or both, as well as psychological and social outcomes. The quality of the evidence was generally moderate.
The systemic review confirmed that individuals who exercised for 45 weeks rated their pain 1.2 points lower on a scale of 0–20 when compared with those who did not exercise—an improvement of 6%. Physical function improved by about 5% over 41 weeks of exercise. Additionally, people’s confidence in what they could do increased by 2% after 35 weeks of exercise. With regard to mental health, people who exercised were 2% less depressed. Overall, the studies indicate that exercise may slightly improve self-efficacy and social function. However, exercise is unlikely to improve anxiety in patients with OA.