Background/Purpose:

The Center for Disease Control and Prevention (CDC) showed that in 2010-2015, 50% of adults 65 years or older reported an arthritis diagnosis. Studies have shown that participation in low-impact physical activity improves pain, function, mood and quality of life without worsening arthritis symptoms or disease severity. Despite this, the people with arthritis are less likely to be physically active. Nearly 44% of adults with arthritis report no leisure-time physical activity. In 2010, 25% of Asian seniors age 65 and older in NYC lived in poverty and were affected by musculoskeletal conditions. Asian women are at increased risk for developing osteoporosis since they tend to be slender with lower bone mass and avoid consuming dairy due to lactose intolerance. To help Asian seniors in underserved communities better manage musculoskeletal conditions, Hospital for Special Surgery developed its Asian Community Bone Health Initiative (ACBHI) in 2011. This study attempts to show that ACBHI improves musculoskeletal outcomes in Asian older adults.  

Methods:

This eight week low-impact exercise program led by bilingual certified instructors, is held once a week in community-based organizations largely serving Asian older adults. Program impact was evaluated with a pre-post design using validated instruments to assess musculoskeletal outcomes. The 11-point Numeric Pain Rating Scale quantified the intensity of muscle or joint pain. Pain interference on seven daily activities was measured using the 11- point Brief Pain Inventory. The SF-36 measured physical function, while the 6-item self-efficacy scale for managing chronic disease was used to measure self-efficacy to exercise. Stiffness and fatigue levels were measured on an 11- point Numeric Rating Scale and 11- point Brief Fatigue Inventory respectively. Demographics such as age, gender and race/ethnicity were also collected. Paired t-test and chi square tests were used for statistical analysis. 

Results:

Between 2011 and 2014, there were 311 participants in the exercise program; 175 responded to bilingual (English/Chinese) surveys. Respondents were mostly female (91%) between 65 and 84 years (75%). Physical function improved with a 69% increase in participants who could lift and carry groceries (p < 0.001); 88% increase in participants that could climb several flights of stairs (p < 0.001); 67% increase in participants who could bend, kneel, or stoop (p < 0.001). Participants’ muscle and joint pain decreased by 32% (p < 0.001). The mean pain intensity rating reduced from 5.6 to 4.4 (p < 0.001). Mean fatigue level dropped from 3.9 to 2.3 (p < 0.001) while the mean stiffness level also dropped from 3.8 to 2.6 (p < 0.001). Reductions in mean pain interference were seen in all seven daily activities. Participants reported that their exercise confidence increased from 6.9 to 8.5 (p <0.001).

Conclusion:

Results indicate that this community-based low-impact exercise program is successful in helping Asian seniors in underserved communities improve musculoskeletal outcomes. Providing free exercise programs to the community can play an important role in improving exercise, and managing musculoskeletal disorders.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-effectiveness-of-low-impact-exercise-program-on-musculoskeletal-health-of-asian-older-adults/