Exercise Optimizes Physical Function, Quality of Life in Hip and Knee OA

Regular exercise improves physical function and health-related quality of life among patients with osteoarthritis.

In individuals with hip and knee osteoarthritis (OA), the maintenance of exercise/physical activity optimizes physical function and health-related quality of life (HRQOL), according to study findings published in Arthritis Research & Therapy.

Limited data are available on the long-term positive impact of regular exercise on physical function and HRQOL in individuals with hip and knee OA.

Using data from the Portuguese Epidemiology of Chronic Diseases (EpiDoC) cohort, researchers sought to evaluate the effect of physical activity on HRQOL and physical function over a long-term follow-up in patients with OA.

Adults enrolled in EpiDoC between 2011 and 2013 were included in the study, which consisted of 4 waves of assessment. The first wave, or baseline evaluation, which included 10,661 individuals who represented the Portuguese adult population, was conducted in 2 phases. The first phase was a structured face-to-face interview in which individuals were screened for musculoskeletal and rheumatic diseases. In the second phase, a rheumatologist conducted a structured assessment to corroborate the diagnosis of any musculoskeletal and rheumatic diseases.

These findings raise awareness of the importance of maintaining exercise/physical activity long term to optimize HRQoL and physical function.

Three subsequent follow-up waves were then conducted using semistructured telephone interviews.

The study population included individuals with an OA diagnosis, based on the American College of Rheumatology (ACR) classification criteria.

Physical function was evaluated using the Health Assessment Questionnaire (HAQ). A total score was calculated for the HAQ, which ranged from 0 (no disabilities) to 3 (complete disability). The HRQOL was measured with the Portuguese validated version of the European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L) questionnaire, which included mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

The analysis included 1086 individuals with OA who were followed-up with for a mean period of 4.7±3.4 years. Overall, 71.3% of the participants were women. The mean patient age was 65.4±11.4 years. In all, 41.3% of the participants had overweight and 39.8% had obesity. A total of 6.3% reported frequent physical activity and 14.9% reported very frequent physical activity.

The regular weekly frequency of intentional physical activity was self-reported as nonfrequent (0 times per week), frequent (1 to 2 times per week), and very frequent (≥3 times per week).

According to univariate analysis, participants who reported nonfrequent physical activity were older, with 24.9% aged at least 75 years. In addition, the group that reported nonfrequent vs frequent or very frequent physical activity included a significantly higher percentage of individuals with a lower level of education (ie, 28.1% reported <4 years of education; P <.001).

Further, a higher percentage of the nonfrequent physical activity subgroup compared with other subgroups reported multimorbidities (73.4%; P =.036). In addition, a higher percentage of individuals in the unmanageable pain group compared with other subgroups reported nonfrequent physical activity (75.9%; P =.017). Researchers noted a higher percentage of individuals with low clinical disease severity in the frequent and very frequent physical activity subgroups compared with the nonfrequent physical activity subgroup (38.5% and 49.7% vs 30.4%, respectively; P <.001).

Study limitations included that the researchers did not control for type, duration, or intensity of physical activity sessions; the lack of consideration of the different types of physical activity; and the inability to distinguish between exercise and levels of physical activity.

“These findings raise awareness of the importance of maintaining exercise/physical activity long term to optimize [HRQOL] and physical function,” the researchers noted. “Further studies must address barriers and facilitators to improve the adoption of regular physical activity among citizens with [hip and knee] OA,” they concluded.

This article originally appeared on Rheumatology Advisor


Lopes DG, Costa D, Cruz EB, et al. Association of physical activity with physical function and quality of life in people with hip and knee osteoarthritis: longitudinal analysis of a population-based cohort. Arthritis Res Ther. 2023;25(1):14. doi:10.1186/s13075-023-02996-x