Background/Purpose: The Centers for Disease Control and Prevention (CDC) reports that about 27 million adults were affected by osteoarthritis (OA) in 2005.  OA is characterized by degeneration of cartilage and bone within a joint, leading to pain and joint stiffness.  Its effects are not just physical; lifestyle also declines (NIAMS).  Research has shown that physical activity reduces pain, improves physical function, and delays disability in people with OA.  Among older adults with knee OA, engaging in moderate physical activity at least 3 times per week can reduce the risk of arthritis related disability by 47%.  However, almost 44% of adults with doctor-diagnosed arthritis report no leisure time physical activity compared with 36% of adults without arthritis (CDC).  This specialty orthopedic hospital developed its Osteoarthritis Wellness Initiative, comprised of educational and exercise programs, to raise awareness, educate and reduce the impact of OA.  This study attempts to support the efficacy of hospital-based exercise programs in increasing physical activity and improving quality of life (QOL) through pain reduction in the older adult community.

Methods: This prospective cohort study assesses the impact of participation in exercise classes on self-reported pain, balance, falls and level of physical activity, based on responses to a pre/post-test survey of 120 participants conducted in the Fall of 2011. The 11-point Numeric Pain Intensity Scale was used to quantify the intensity of muscle or joint pain.  Pain interference on aspects of QOL (general activity, mood, walking ability, sleep, enjoyment of life etc.) was measured using items from the 10-point Brief Pain Inventory.  Participants were asked to rate their balance on a 6-point rating scale, while self-reported number of falls and fall severity was assessed on a 5-point scale.  Independent sample t-tests were performed to measure changes in mean pain intensity, pain interference scores, physical activity and fall severity scores from pre- to post test.  Chi square tests were conducted to ascertain whether reports of pain, balance ratings and physical activity significantly changed from pre- to post test.  Demographics such as age, gender and race/ethnicity were also collected.

Results: Most respondents were female (88.6%) with the majority ages 65+ (77.3%). The proportion of respondents who reported pain decreased from pre- to post test (73.4% to 56.5%).  Statistically significant differences (p < 0.001) were found in mean pain intensity ratings between pre- and post test (pre-test = 5.1; post-test = 2.8).  Significant differences in pain interference scores were found with regard to mood, walking ability and enjoyment of life (p < 0.05).  Balance ratings improved, number and severity of falls diminished and vigorous physical activity increased.

Conclusion: Preliminary results indicate that providing low cost exercise programs to the community can play an important role in fighting OA with minimal resources.  Data indicate that hospital-based exercise classes are associated with positive changes in pain, fitness and QOL, suggesting these exercise programs may play an important role in alleviating and/or minimizing symptoms of OA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/hospital-for-special-surgery-osteoarthritis-wellness-initiative-the-impact-of-a-hospital-based-exercise-program-on-osteoarthritis/