title: Physical activity levels and functional performance in the osteoarthritis initiative: a graded relationship. Does Adherence Make a Difference?: Results From a Community-Based Aquatic Exercise Program Longitudinal study of the long-term relation between physical activity and obesity in adults Moving to maintain function in knee osteoarthritis: evidence from the osteoarthritis initiative.
abstract: OBJECTIVE Physical activity improves function in adults with arthritis , but it is unknown if there is a grade d relationship between physical activity and functional benefit . This study was undertaken to examine the cross-sectional and longitudinal relationship between self-reported physical activity and observed functional performance in adults with knee osteoarthritis ( OA ) . METHODS The Osteoarthritis Initiative cohort included 2,589 patients with knee OA ( 2,301 with longitudinal followup data ) who were ages 45 - 79 years at baseline . Prospect i ve annual functional performance was assessed for 2 years using timed 20-meter walk tests .  We used linear regression to estimate differences across physical activity quartiles in subsequent function ( baseline and 1-year activity predicts 1-year and 2-year function , respectively ) adjusted for demographic factors ( age , sex , race/ethnicity , education level , and marital status ) and health factors ( OA severity , knee symptoms , knee pain , knee injury , body mass index , comorbidity , depression , smoking , alcohol use , and other joint pain ) . RESULTS Increasing physical activity levels had a significant grade d relationship to functional performance . Adults in physical activity quartile groups from least active to most active had an average gait speed of 4.0 , 4.2 , 4.3 , and 4.5 feet/second , respectively , at baseline ( P for trend<0.001 ) and 4.0 , 4.2 , 4.3 , and 4.5 feet/second , respectively , after 1 year ( P for trend<0.001 ) ; increasing trends remained significant after adjusting for covariates . Findings were similar within sex and age groups . CONCLUSION These prospect i ve data indicate a consistent grade d relationship between physical activity level and better performance in adults with knee OA . These findings support guidelines that encourage patients with arthritis who can not attain minimum recommended physical activity to be as active as possible Background Evidence exists demonstrating the benefits of exercise for people with osteoarthritis , but little is known about whether exercise programs are effective , that is , whether the benefits of exercise can be seen in “ real life ” programs for “ normal ” people under nonlaboratory conditions . Objective To identify characteristics of and outcomes for participants who adhere to a community-based aquatic exercise program .  Method Two hundred and forty-nine adults with osteoarthritis were recruited from Washington State for r and omization to a 20-week Arthritis Foundation aquatic exercise program ( n = 125 ) or a wait-list control group ( n = 124 ) . Adherers were defined as those attending at least two classes per week for 16 of 20 weeks . Measures included : Quality of Well Being Scale , Health Assessment Question naire , Center for Epidemiological Studies -Depression Scale , and a single arthritis quality of life rating-item . Results Baseline to postintervention change scores revealed that treatment-group adherers ( N = 35 ) reported improved quality of well-being , physical function , and change in arthritis quality of life compared to controls ( N = 124 ) . When comparing treatment-group adherers ( N = 35 ) to treatment-group nonadherers ( N = 67 ) , quality of well-being and depressed mood improved for adherers , but not for nonadherers . Conclusion When analyzed for level of participation , exercise benefits adults with osteoarthritis . Consistent participation in exercise programs results in better outcomes . Improved methods are needed to enhance adherence , with increased attention to the role of intrinsic factors such as self-efficacy and belief systems BACKGROUND : Earlier observational studies of the relation between physical activity and obesity are inconsistent and ambiguous , showing a clear cross-sectional inverse relation , and a prospect i ve association only when physical activity at the time of follow-up is included . OBJECTIVE : To examine the long-term effect of leisure time physical activity ( LTPA ) on subsequent development of obesity and the effect of body weight on later physical inactivity in a population -based longitudinal setting taking into account the effects of historical changes on future changes as well as pertinent confounders . DESIGN : The study included 3653 women and 2626 men aged 20–78 y selected at r and om within sex – age strata from the general population of Copenhagen . At two surveys , 5 y apart ,  LTPA , body mass index ( BMI ) ( weight/height2 , kg/m2 ) , several possible confounders and modifying factors were assessed . Obesity ( defined as BMI ≥30 kg/m2 ) and LTPA was assessed at the 3rd survey 10 y later . Odds ratios ( with 95 % confidence limits ) for developing obesity between the last two surveys were estimated by logistic regression analysis , taking into account baseline and preceding changes in BMI and LTPA . A similar analysis of odds ratios for physical inactivity as outcome at the 3rd survey was conducted . RESULTS : Compared to physical inactivity , the odds ratios of development of obesity among women with medium and high level of activity were 0.81 ( 0.53 , 1.25 ) and 1.16 ( 0.73 , 1.84 ) , respectively , and among men , the odds ratios were 1.28 ( 0.71 , 2.33 ) and 1.65 ( 0.91 , 2.99 ) , respectively . Compared to median BMI , the odds ratio of later physical inactivity among women with high BMI was 1.91 ( 1.39 , 2.61 ) , and among men the odds ratio was 1.50 ( 1.01 , 2.22 ) . The associations were not confounded or modified by age , pre-existing diseases , smoking , alcohol intake , educational level , occupational physical activity or by familial predisposition to obesity . CONCLUSION : This study did not support that physical inactivity as reported in the freely living adult population in the long term is associated with the development of obesity , but the study indicates that obesity may lead to physical inactivity OBJECTIVES To investigate the association between baseline physical activity and 1-year functional performance in adults with knee osteoarthritis ( OA ) . DESIGN Prospect i ve cohort study of knee OA development and progression with 1-year follow-up . SETTING Community . PARTICIPANTS Osteoarthritis Initiative public data on adults with knee OA ( n=2274 ; age , 45 - 79y ) who participated in functional performance assessment s ( timed 20-m walk and chair st and test ) at baseline and 1-year follow-up . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURE A good 1-year performance outcome ( separately defined for walk time and chair st and measures ) was improvement from baseline quintile or maintenance in the best quintile . RESULTS Almost 2 in 5 persons with radiographic knee OA improved or maintained high performance at 1 year .  Physical activity  measured by the  Physical Activity Scale for the Elderly  ( PASE ) was significantly associated with good walk rate and chair st and outcomes ( odds ratio per 40 units PASE [ 95 % confidence interval]=1.13 [ 1.13 , 1.17 ] and 1.10 [ 1.05 , 1.15 ] , respectively ) , as were participation in sports/recreational activities ( 1.45 [ 1.23 , 1.71 ] and 1.29 [ 1.09 , 1.51 ] , respectively ) and lifestyle activities ( 1.11 [ 1.06 , 1.16 ] and 1.09 [ 1.04 , 1.14 ] , respectively ) . An independent protective relationship for these physical activity measures approached significance after adjusting for sociodemographic and health factors . Older adults reported the least baseline physical activity and least frequent good 1-year outcomes . CONCLUSIONS These findings support public health recommendations to be physically active in order to preserve function for persons with knee OA .  Physical activity messages should specifically target older adults whose low activity levels may jeopardize their ability to maintain functional performance
target: For patients with knee OA there is limited evidence that a lower level of physical function is associated with a lower level of physical activity .
  There is also limited evidence that depression is not associated with the level of physical activity .
  For patients with hip OA there is limited evidence that higher age , higher body mass index ( BMI ) and a low level of physical function is associated with a low level of physical activity .
  CONCLUSION A high age ( hip OA ) , a high BMI ( hip OA ) and a low level of physical function ( both hip and knee OA ) are related to a low level of physical activity .
background: OBJECTIVE To give an overview of factors related to the level of physical activity  in patients with hip or knee osteoarthritis ( OA ) .