Exercise reduces 'activities of daily living disability' in elderly people with knee osteoarthritis

Li, Chung-Yi PhD

Fu Jen Catholic University; Hsinchuang, Taipei Hsien, Taiwan

Abstracted from:Penninx BWJH, Messier SP, Rejeski WJ, Williamson JD, DiBari M, Cavazzini C, Applegate WB, Pahor M. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med 2001; 161: 2309-2316 .

Evidence-based Healthcare 6(2):p 83-84, June 2002.

BACKGROUND

Lack of physical exercise increases mobility problems in the elderly. There have been few trials assessing the effectiveness of exercise in preventing disability in the activities of daily living (ADL disability).

OBJECTIVE

To assess the effectiveness of an exercise programme for preventing ADL disability in elderly people with knee osteoarthritis.

SETTING

Two centres location not stated; date not stated.

METHOD

Randomised controlled trial.

PARTICIPANTS

Two hundred and fifty over 60-year olds with knee osteoarthritis confirmed by X-ray; knee pain on most days of the month and difficulty with at least one of the following: climbing stairs; walking 0.4 km; getting in and out of the bath, car or bed; getting out of a chair; shopping; cleaning or self-care activities. People with inflammatory arthritis and those who were unable to walk 128 m in 6 minutes, exercised at least 20 minutes per week or had a medical condition making exercise unsafe were excluded.

INTERVENTION

Aerobic exercise programme, resistance exercise programme or control group. The aerobic programme involved a 10 minute warm-up, walking for 40 minutes followed by a 10 minute cool down, three times per week. The resistance programme consisted of three 1 hour sessions each week (10 minute warm-up and cool down and 40 minutes of exercises using dumbbells and cuff weights). Both exercise programmes began at a supervised facility for 3 months followed by a 15-month home-based programme. Compliance was assessed by attendance, exercise logs and telephone support. The control group attended monthly arthritis educational sessions, bimonthly for 3 months and monthly thereafter.

OUTCOMES

ADL disability.

MAIN RESULTS

Both exercise groups had a lower cumulative incidence of ADL disability than the control group (Table 1). Participants with the highest compliance had the lowest risk of ADL disability.

Table 1 Incidence of 'disability in activities of daily living' amongst elderly people
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AUTHORS' CONCLUSIONS

ADL disability may be reduced by exercise in older persons with knee osteoarthritis.

NOTES

Of 439 participants randomised at baseline, 178 were excluded due to baseline ADL disability. Some level of baseline disability was also a criteria for inclusion, however, (difficulties with walking 0.4 km; climbing stairs; getting in and out of the bath, car or bed; getting out of a chair; shopping; cleaning or self-care activities).