Moving to maintain function in knee osteoarthritis: evidence from the osteoarthritis initiative. Physical activity levels and functional performance in the osteoarthritis initiative: a graded relationship. Activity Increase Despite Arthritis (AÏDA): phase II randomised controlled trial of an active management booklet for hip and knee osteoarthritis in primary care. The effects of a health educational and exercise program for older adults with osteoarthritis for the hip or knee. Primary care-based physical activity programs: effectiveness in sedentary older patients with osteoarthritis symptoms. A Community-Based Physical Activity Counselling Program for People With Knee Osteoarthritis: Feasibility and Preliminary Efficacy of the Track-OA Study The effects of an exercise program for older adults with osteoarthritis of the hip. Activity Increase Despite Arthritis (AÏDA): design of a Phase II randomised controlled trial evaluating an active management booklet for hip and knee osteoarthritis [ISRCTN24554946] The Arthritis, Diet and Activity Promotion Trial (ADAPT): design, rationale, and baseline results. Community rehabilitation for older adults with osteoarthritis of the lower limb: a controlled clinical trial Effectiveness of a Web-Based Physical Activity Intervention in Patients With Knee and/or Hip Osteoarthritis: Randomized Controlled Trial Adherence to a Web-Based Physical Activity Intervention for Patients With Knee and/or Hip Osteoarthritis: A Mixed Method Study Risk factors for the development of hip osteoarthritis: a population-based prospective study. Randomized Controlled Trial Investigating the Role of Exercise in the Workplace to Improve Work Ability, Performance, and Patient-Reported Symptoms Among Older Workers With Osteoarthritis Factors associated with change in pain and disability over time: a community-based prospective observational study of hip and knee osteoarthritis. Does hand osteoarthritis predict future hip or knee osteoarthritis? The effect of aquatic exercise and education on lowering fall risk in older adults with hip osteoarthritis.
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 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 The Hip & Knee Book : Helping you cope with osteoarthritis was developed to change disadvantageous beliefs and encourage physical activity in people with hip or knee osteoarthritis . AIM To assess the feasibility of conducting a definitive r and omised controlled trial ( RCT ) of this evidence -based booklet in people with hip or knee osteoarthritis . DESIGN Phase II feasibility r and omised controlled trial ( RCT ) . METHOD Computerised search es of patients ' record data bases identified people with osteoarthritis of the hip or knee , who were invited to participate in the RCT comparing the new booklet with a control booklet . Outcomes were measured at baseline , 1 month , and 3 months , and included : beliefs about hip and knee pain , exercise , and fear avoidance ; level of physical activity ; and health service use . RESULTS The trial methods were feasible in terms of recruitment , r and omisation , and follow-up , but most participants recruited had longst and ing established symptoms . After one and 3 months , there was a small relative improvement in illness , exercise , and fear-avoidance beliefs and physical activity level in The Hip & Knee Book group ( n = 59 ) compared with the control group ( n = 60 ) , which provides some proof of principle for using these outcomes in future trials . CONCLUSION This feasibility study provided proof of principle for testing The Hip & Knee Book in a larger definitive RCT OBJECTIVE Evaluation of a self-management program for patients with osteoarthritis ( OA ) of the hip or knee . The program , which consisted of 6 weekly sessions of 2 hours , included health education by a peer and physical exercises taught by a physical therapist . METHODS R and omized controlled trial . Inclusion criteria were diagnosis of OA of the hip or knee according to ACR clinical and radiographic criteria and age 55 to 75 years . EXCLUSION CRITERIA on waiting list for joint replacement . There were pretest , posttest , and followup ( 6 months ) assessment s. The experimental group consisted of 56 patients , the control group 49 . Outcome variables were pain , quality of life , activity restrictions , knowledge about OA , self-efficacy , body mass index ( BMI ) , and mobility measures . Attention was also paid to effects on health care utilization and lifestyle behavior . RESULTS Significant MANOVA group x time effects ( p < 0.05 , one-sided ) were found for pain , quality of life , strength of the left M. quadriceps , knowledge , self-efficacy , BMI , physically active lifestyle , and visits to the physical therapist . Most effects were moderate at posttest assessment and smaller at followup . No effects were found for range of motion and functional tasks . CONCLUSION The program was reasonably effective , but more attention should be paid to proactive followup interventions and to the selection of participants OBJECTIVE This study examined , in a group of older patients , ( a ) the effectiveness of an invitation to participate in a program providing individualized physical activity advice in a primary care setting and ( b ) the changes in self-reported physical activity and symptoms in patients with osteoarthritis ( OA ) . METHODS Healthy , sedentary community-dwelling men and women aged 60 years or more were invited to participate . Following r and om allocation , the intervention group received individualized physical activity advice at baseline and at 3 , 6 , and 12 months followup . RESULTS Of the 299 people who satisfied the study 's inclusion criteria , a subgroup of 69 people reported pain and stiffness of the hip or knee at baseline . These patients reported increases in frequency and time of walking and vigorous exercise ( all P < 0.001 ) , with no change to OA symptom scores ( pain and stiffness ) , and a small decline in physical functioning was reported at 12 months followup in the control group only ( P = 0.027 ) . At the 12-month followup more intervention participants than control participants ( P = 0.013 ) reported a greater intention to exercise . CONCLUSIONS An offer of primary care-based physical activity advice , with an emphasis on the benefits for general health ( rather than " treatment " for OA ) , will attract individuals with OA symptoms . Although the present study was unable to demonstrate intervention-control group differences for the majority of outcomes , intention to exercise did appear to be positively influenced Background Physical activity can improve health outcomes in people with knee osteoarthritis ( OA ) ; however , participation in physical activity is very low in this population . Objective The objective of our study was to assess the feasibility and preliminary efficacy of the use of wearables ( Fitbit Flex ) and telephone counselling by a physical therapist ( PT ) for improving physical activity in people with a physician-confirmed diagnosis of knee OA , or who have passed 2 vali date d criteria for early OA . Methods We conducted a community-based feasibility r and omized controlled trial . The immediate group ( n=17 ) received a brief education session by a physical therapist , a Fitbit Flex activity tracker , and a weekly telephone call for activity counselling with the physical therapist . The delayed group ( n=17 ) received the same intervention 1 month later . All participants were assessed at baseline ( T0 ) , and the end of 1 month ( T1 ) and 2 months ( T2 ) . Outcomes were ( 1 ) mean moderate to vigorous physical activity time , ( 2 ) mean time spent on sedentary behavior , ( 3 ) Knee Injury and Osteoarthritis Outcome Score ( KOOS ) , and ( 4 ) Partners in Health Scale . Feasibility data were summarized with descriptive statistics . We used analysis of covariance to evaluate the effect of the group type on the outcome measures at T1 and T2 , after adjusting for blocking and T0 . We assessed planned contrasts of changes in outcome measures over measurement periods . Results We identified 46 eligible individuals ; of those , 34 ( 74 % ) enrolled and no one dropped out . All but 1 participant adhered to the intervention protocol . We found a significant effect , with the immediate intervention group having improved in the moderate to vigorous physical activity time and in the Partners in Health Scale at T0 to T1 compared with the delayed intervention group . The planned contrast of the immediate intervention group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in the sedentary time and the KOOS symptoms subscale , favoring the delayed group . Conclusions This study demonstrated the feasibility of a behavioral intervention , supported by the use of a wearable device , to promote physical activity among people with knee OA . Trial Registration Clinical Trials.gov NCT02313506 ; https:// clinical trials.gov/ct2/show/NCT02313506 ( Archived by WebCite at http://www.webcitation.org/6r4P3Bub0 OBJECTIVE . Evaluation of an 8-week exercise program with strength training and lifestyle advice for older adults with osteoarthritis ( OA ) of the hip . Outcome measures were pain , hip function , disability , quality of life ( QOL ) , and body mass index ( BMI ) . METHODS Inclusion criteria for this r and omized controlled trial were : age > or=55 years , clinical diagnosis of OA according to American College of Rheumatology criteria , and living independently . Interview and physical data were collected at baseline , post-test , and followup ( 3 mo ) by trained interviewers and physical therapists with vali date d instruments : Harris Hip Score , Sickness Impact Profile , Groningen Activity Restriction Scale , functional tests ( walking , timed Up & Go , ascending and descending stairs , and toe reaching ) , and visual analog scales ( pain and QOL ) . Data were analyzed on an intention-to-treat basis . Effect sizes were calculated . RESULTS There were 109 participants ( 55 experimental , 54 controls ) . The 15 participants who dropped out were characterized by less tolerance to pain and younger age . The program had a positive effect on pain ( moderate effect at post-test and small effect at followup ) , hip function ( small effect at post-test ) , self-reported disability ( small effect at followup ) , and the timed Up & Go test ( small effect at followup ) . It did not affect QOL , other measures of observed disability , or BMI . CONCLUSION The exercise program had positive effects on pain and hip function , which are important mediators of disability . This study fulfilled a need for older adults with hip OA and provides evidence of the benefit of exercise in the management of hip OA Background Hip and knee osteoarthritis is a common cause of pain and disability , which can be improved by exercise interventions . However , regular exercise is uncommon in this group because the low physical activity level in the general population is probably reduced even further by pain related fear of movement . The best method of encouraging increased activity in this patient group is not known . A booklet has been developed for patients with hip or knee osteoarthritis . It focuses on changing disadvantageous beliefs and encouraging increased physical activity . Methods / Design This paper describes the design of a Phase II r and omised controlled trial ( RCT ) to test the effectiveness of this new booklet for patients with hip and knee osteoarthritis in influencing illness and treatment beliefs , and to assess the feasibility of conducting a larger definitive RCT in terms of health status and exercise behaviour . A computerised search of four general medical practice patients ' record data bases will identify patients older than 50 years of age who have consulted with hip or knee pain in the previous twelve months . A r and om sample of 120 will be invited to participate in the RCT comparing the new booklet  with a control booklet , and we expect 100 to return final question naires . This trial will assess the feasibility of recruitment and r and omisation , the suitability of the control intervention and outcome measurement tools , and will provide an estimate of effect size . Outcomes will include beliefs about hip and knee pain , beliefs about exercise , fear avoidance , level of physical activity , health status and health service costs . They will be measured at baseline , one month and three months . Discussion We discuss the merits of testing effectiveness in a phase II trial , in terms of intermediate outcome measures , whilst testing the processes for a larger definitive trial . We also discuss the advantages and disadvantages of testing the psychometric properties of the primary outcome measures concurrently with the trial . Trial registration Current Controlled Trials IS RCT Osteoarthritis ( OA ) of the knee leads to restrictions of physical activity and ability to perform activities of daily living . Obesity is a risk factor for knee OA and it appears to exacerbate knee pain and disability . The Arthritis , Diet , and Activity Promotion Trial ( ADAPT ) was developed to test the efficacy of lifestyle behavioral changes on physical function , pain , and disability in obese , sedentary older adults with knee OA . This controlled trial r and omized 316 sedentary overweight and obese older adults in a two-by-two factorial design into one of four 18-month duration intervention groups : Healthy Lifestyle Control ; Dietary Weight Loss ; Structured Exercise ; or Combined Exercise and Dietary Weight Loss . The weight-loss goal for the diet groups was a 5 % loss at 18 months . The intervention was modeled from principles derived from the group dynamics literature and social cognitive theory . Exercise training consisted of aerobic and strength training for 60 minutes , three times per week in a group and home-based setting . The primary outcome measure was self-report of physical function using the Western Ontario and McMaster University Osteoarthritis Index . Other measurements included timed stair climb , distance walked in 6 minutes , strength , gait , knee pain , health-related quality of life , knee radiographs , body weight , dietary intake , and cost-effectiveness of the interventions . We report baseline data stratified by level of overweight and obesity focusing on self-reported physical function and physical performance tasks . The results from ADAPT will provide approaches clinicians should recommend for behavioral therapies that effectively reduce the incidence of disability associated with knee OA Objective : To examine the effectiveness of a 12-month community-based water exercise programme on measures of self-reported health and physical function in people aged over 60 years old with knee-hip osteoarthritis ( OA ) . Design : A quasi-experimental design consisting of an exercise group and an age-matched control group . Setting : Public community swimming pool in Sheffield , UK . Subjects : One hundred and six community-dwelling sedentary older people , with confirmed knee-hip osteoarthritis , enrolled in an experimental controlled trial for 12 months . Sixty-six subjects in the exercise group were offered a water-exercise programme .  Forty age-matched , nonexercising , ‘ control ’ subjects received monthly education material and quarterly telephone calls . Interventions : Participants in the exercise group were asked to attend two exercise sessions a week of 1 hour duration led by specially trained swimming instructors . Main measures : Primary outcome measure was the disease-specific Western Ontario and McMaster University Osteoarthritis Index ( WOMAC ) . Secondary outcomes included a battery of performance-based physical function tests . Results : Adherence to exercise averaged 70 % ( ±14 % ) over the year : 77 % of the exercising subjects and 89 % control subjects completed both pre- and post- outcome measures . After one year , participants in the exercise group experienced a significant improvement in physical function ( 4.0 ± 9.1 versus -0.4 ± 7.3 units ; 95 % confidence interval ( CI ) 0.96–7.96 , p < 0.05 ) and reduction in the perception of pain ( 1.3 ± 3.7 versus 0.2 ± 2.5 units ; 95 % CI -0.19 - 2.52 , p < 0.05 ) compared with the control group , as measured by the WOMAC Osteoarthritis Index . In addition , the exercise group performed significantly better in the ascending and descending stairs tests ( p < 0.05 ) , had significantly greater improvements in knee range of movement ( p < 0.01 ) and hip range of movements ( p < 0.005 ) . There were no significant differences in the two groups for quadriceps muscle strength and psychosocial well-being ( Arthritis Impact Measurement Scales 2 question naire ) . Conclusions : Older people with knee/hip osteoarthritis gained modest improvements in measures of physical function , pain , general mobility and flexibility after participating in 12 months of community-based water exercise Background Patients with knee and /or hip osteoarthritis ( OA ) are less physically active than the general population , while the benefits of physical activity ( PA ) have been well documented . Based on the behavioral grade d activity treatment , we developed a Web-based intervention to improve PA levels in patients with knee and /or hip OA , entitled “ Join2move ” . The Join2move intervention is a self-paced 9-week PA program in which the patient ’s favorite recreational activity is gradually increased in a time-contingent way . Objective The aim of the study was to investigate whether a fully automated Web-based PA intervention in patients with knee and /or hip OA would result in improved levels of PA , physical function , and self-perceived effect compared with a waiting list control group . Methods The study design was a two-armed r and omized controlled trial which was not blinded . Volunteers were recruited via articles in newspapers and health-related websites . Eligibility criteria for participants were : ( 1 ) aged 50 - 75 years , ( 2 ) self-reported knee and /or hip OA , ( 3 ) self-reported inactivity ( 30 minutes of moderate PA , 5 times or less per week ) , ( 4 ) no face-to-face consultation with a health care provider other than general practitioners , for OA in the last 6 months , ( 5 ) ability to access the Internet weekly , and ( 6 ) no contra-indications to exercise without supervision . Baseline , 3-month , and 12-month follow-up data were collected through online question naires . Primary outcomes were PA , physical function , and self-perceived effect . In a subgroup of participants , PA was measured objective ly using accelerometers . Secondary outcomes were pain , fatigue , anxiety , depression , symptoms , quality of life , self-efficacy , pain coping , and locus of control . Results Of the 581 interested respondents , 199 eligible participants were r and omly assigned to the intervention ( n=100 ) or waiting list control group ( n=99 ) . Response rates of question naires were 84.4 % ( 168/199 ) after 3 months and 75.4 % ( 150/199 ) after 12 months . In this study , 94.0 % ( 94/100 ) of participants actually started the program , and 46.0 % ( 46/100 ) reached the adherence threshold of 6 out of 9 modules completed . At 3 months , participants in the intervention group reported a significantly improved physical function status ( difference=6.5 points , 95 % CI 1.8 - 11.2 ) and a positive self-perceived effect ( OR 10.7 , 95 % CI 4.3 - 26.4 ) compared with the control group . No effect was found for self-reported PA . After 12 months , the intervention group showed higher levels of subjective ( difference=21.2 points , 95 % CI 3.6 - 38.9 ) and objective PA ( difference=24 minutes , 95 % CI 0.5 - 46.8 ) compared with the control group . After 12 months , no effect was found for physical function ( difference=5 points , 95 % CI −1.0 to 11.0 ) and self-perceived effect ( OR 1.2 , 95 % CI 0.6 - 2.4 ) . For several secondary endpoints , the intervention group demonstrated improvements in favor of the intervention group . Conclusions Join2move result ed in changes in the desired direction for several primary and secondary outcomes . Given the benefits and its self-help format , Join2move could be a component in the effort to enhance PA in sedentary patients with knee and /or hip OA . Trial Registration The Netherl and s National Trial Register : NTR2483 ; http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=2483 ( Archived by WebCite at http://www.webcitation.org/67NqS6Beq ) Background Web-based interventions show promise in promoting a healthy lifestyle , but their effectiveness is hampered by high rates of nonusage . Predictors and reasons for (non)usage are not well known . Identifying which factors are related to usage contributes to the recognition of subgroups who benefit most from Web-based interventions and to the development of new strategies to increase usage . Objective The aim of this mixed methods study was to explore patient , intervention , and study characteristics that facilitate or impede usage of a Web-based physical activity intervention for patients with knee and /or hip osteoarthritis . Methods This study is part of a r and omized controlled trial that investigated the effects of Web-based physical activity intervention .  A total of 199 participants between 50 - 75 years of age with knee and /or hip osteoarthritis were r and omly assigned to a Web-based intervention ( n=100 ) or a waiting list ( n=99 ) . This mixed methods study used only data from the individuals allocated to the intervention group . Patients were defined as users if they completed at least 6 out of 9 modules .  Logistic regression analyses with a stepwise backward selection procedure were executed to build a multivariate prediction usage model . For the qualitative part , semistructured interviews were conducted . Both inductive and deductive analyses were used to identify patterns in reported reasons for nonusage . Results Of the 100 participants who received a password and username , 46 completed 6 modules or more . Multivariate regression analyses revealed that higher age ( OR 0.94 , P=.08 ) and the presence of a comorbidity ( OR 0.33 , P=.02 ) predicted nonusage . The sensitivity analysis indicated that the model was robust to changes in the usage parameter . Results from the interviews showed that a lack of personal guidance , insufficient motivation , presence of physical problems , and low mood were reasons for nonusage . In addition , the absence of human involvement was viewed as a disadvantage and it negatively impacted program usage . Factors that influenced usage positively were trust in the program , its reliability , functionality of the intervention , social support from family or friends , and commitment to the research team . Conclusions In this mixed methods study , we found patient , intervention , and study factors that were important in the usage and nonusage of a Web-based PA intervention for patients with knee and /or hip osteoarthritis . Although the self-guided components offer several advantages , particularly in relation to costs , reach , and access , we found that older patients and participants with a comorbid condition need a more personal approach . For these groups the integration of Web-based interventions in a health care environment seems to be promising . Trial Registration The Netherl and s National Trial Register ( NTR ) : NTR2483 ; http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=2483 ( Archived by Webcite at http://www.webcitation.org/67NqS6Beq ) OBJECTIVES Potential risk factors and their roles in the aetiology of hip OA are poorly understood . We analysed several alleged risk factors predisposing to hip OA in a 22-yr prospect i ve study . METHODS A comprehensive health survey was carried out in 1978 - 80 in a nationally representative sample of adult Finns . In 2000 - 01 , 1286 participants in that survey were invited for re-examination , and 909 agreed to participate . After excluding those with hip OA at the baseline and those who were no longer working , a total of 840 subjects constituted the present study population . Hip OA was diagnosed on the basis of a st and ardized clinical examination by physicians who applied uniform criteria both at the baseline and at the re-examination phase . RESULTS After 22 yrs of follow-up , hip OA was diagnosed in 41 subjects ( 4.9 % ) . Heavy manual labour predicted the risk of developing hip OA [ adjusted odds ratio ( OR ) 6.7 ; 95 % CI 2.3 , 19.5 ] . Permanent damage as a consequence of any musculoskeletal injury was also an independent predictor of hip OA ( adjusted OR 5.0 ; 95 % CI 1.9 , 13.3 ) . BMI , smoking , alcohol intake and leisure time physical activity were not factors which were predictive for hip OA . CONCLUSION Heavy physical stress at work and major musculoskeletal injuries are associated with an increased risk of developing clinical ly diagnosed hip OA Objective : The aim of this study was to evaluate the effectiveness of a 12-week workplace exercise program on work ability , performance , and patient-reported symptoms in older university employees with knee and /or hip osteoarthritis . Methods : Twenty-four participants with clinical hip and /or knee osteoarthritis were r and omized to exercise or no exercise . At baseline and follow-up , several work ( work ability , resilience ) , patient-reported ( pain , physical function , depressive symptoms , self-efficacy ) , and performance outcomes ( hip and knee strength , mobility performance ) were measured . Results : Significant improvements in work ability ( P < 0.049 ) and patient-reported outcomes ( pain , function , depressive symptoms ) existed in the exercise group . No improvements were demonstrated in the no exercise group . Conclusions : Exercise in the workplace improved work ability and patient-reported symptoms in older workers with osteoarthritis . The benefits of workplace exercise programs should be studied in a larger sample in which attention is given to improving exercise adherence BACKGROUND Hip and knee osteoarthritis are frequent causes of primary care consultations . They are considered slowly progressive disorders , often result ing in severe pain or disability and the need for joint replacements . There have been few longitudinal studies of progression to inform individual prognoses in primary care . AIM To describe the degree of progression and investigate predictors of change in hip or knee pain and disability . DESIGN OF STUDY Prospect i ve community-based cohort . SETTING An age-sex stratified survey of 27 000 people registered with 40 general practice s in Avon and Somerset yielded 2437 reporting hip and /or knee symptoms at baseline ( 1992 - 1994 ) . A 25 % r and om sample of 587 individuals was followed up between 1998 and 1999 . METHOD Pain or disability was measured at baseline and followup using the New Zeal and score  . For the worst joint according to the New Zeal and score at baseline , hip and knee problems were analysed separately . Regression models ascertained characteristics of nonresponders and factors associated with change in scores . Seven sociodemographic , seven comorbidity , and two healthcare utilisation variables were considered . RESULTS Generally pain and disability worsened over the 7 years , but 35 % and 29 % of those initially reporting hip and knee pain respectively had improved . Reporting " other health problems " was associated with greater deterioration for both hip and knee disease , as was cardiovascular morbidity for hip disease and lower social class , being retired , hypertension , and higher body mass index for knee disease . Deteriorations in scores were strongly associated with individuals consulting their GP about joint problems . CONCLUSION Osteoarthritis does not invariably deteriorate , but when it does social as well as biological factors appear to be important . These findings may aid outcome prediction . Future research on osteoarthritis should be conducted within a biopsychosocial rather than a purely biological paradigm OBJECTIVE To evaluate the risk of future hip or knee osteoarthritis ( OA ) in subjects with h and OA at baseline and to evaluate whether the concurrent presence of h and OA , other risk factors for OA , or an OA biomarker ( type II collagen C-telopeptide degradation product [ CTX-II ] ) further increases the risk . METHODS Radiographs of the h and s ( baseline ) and the hips and knees ( baseline and 6.6 years later ) were obtained in a r and omly selected subset of participants in the Rotterdam Study who were ages 55 years and older . Radiographs were scored for the presence of OA using the Kellgren/Lawrence ( K/L ) system . A total of 1,235 subjects without OA of the hip/knee ( K/L score 0 - 1 ) at baseline were included in the study . CTX-II levels were measured at baseline . The independent risk of future hip/knee OA in subjects with h and OA at baseline was assessed by logistic regression , as stratified for age , sex , body mass index , family history of OA , and heavy workload . RESULTS Overall 12.1 % of the participants ( 19.7 % of those with h and OA versus 10.0 % of those without ) developed hip or knee OA ( odds ratio [ OR ] 2.1 [ 95 % confidence interval ( 95 % CI ) 1.3 - 3.1 ] ) . Subjects with h and OA had an increased risk of future hip OA ( OR 3.0 [ 95 % CI 1.6 - 5.4 ] ) , which was further increased in those with a family history of OA . Subjects with h and OA had an OR of 1.6 [ 95 % CI 1.0 - 2.8 ) for the future development of knee OA , which was further increased in those who were overweight . Concurrent h and OA and high levels of CTX-II further increased the risk of having hip or knee OA at followup ( OR 4.2 [ 95 % CI 2.3 - 7.8 ] ) . CONCLUSION The presence of h and OA at baseline showed an increased risk of future hip/knee OA ( higher for hip OA than for knee OA ) . The concurrent presence of h and OA and other OA risk factors or high CTX-II levels further increased the risk of future hip/knee OA OBJECTIVE To evaluate the effect of aquatic exercise and education on fall risk factors in older adults with hip osteoarthritis ( OA ) . METHOD Seventy-nine adults , 65 years of age or older with hip OA and at least 1 fall risk factor , were r and omly assigned to 1 of 3 groups : aquatics and education ( AE ; aquatic exercise twice a wk with once-a-wk group education ) , aquatics only ( A ; 2 wk aquatic exercise ) and control ( C ; usual activity ) . Balance , falls efficacy , dual-task function , functional performance ( chair st and s ) , and walking performance were measured pre- and postintervention or control period . RESULTS There was a significant improvement in fall risk factors ( full-factorial MANCOVA , baseline values as covariates ; p = .038 ) ; AE improved in falls efficacy compared with C and in functional performance compared with A and C. CONCLUSION The combination of aquatic exercise and education was effective in improving fall risk factors in older adults with arthritis
Social ( e.g. support from spouse ( n = 141 ) ) and environment ( outdoor temperature ( n = 38 ) ) factors were identified as possible factors that influence physical activity .
Conclusion : Demographic , physical , social , psychological and environmental factors are all important correlates for physical activity for people with knee or hip osteoarthritis .
Objective : To determine the factors associated with physical activity participation in adults with hip or knee osteoarthritis .