Treating disability in knee osteoarthritis with exercise therapy: A central role for self‐efficacy and pain

Abstract

Objective. To examine the effects of aerobic and resistance exercise on selfieficacy beliefs in older adults with knee osteoarthritis [OA)

Physical activity levels among the general US adult population and in adults with and without arthritis

“…Despite the fact that multiple clinical trials have shown that PA and exercise are beneficial for people with arthritis, almost one-third of persons with arthritis are completely inactive, and only one-quarter get enough PA to comply with national PA recommendations (13)(14)(15)(16)). Yet, it is possible for persons with arthritis to meet the national recommendations by engaging in moderate types of joint friendly PA such as walking, gardening, bicycling, and swimming.…”

“…Because arthritis is the leading cause of disability, one benefit of increasing PA levels may be decreasing the development of arthritis-related disability (17). Evidence from randomized clinical trials suggests that PA, both aerobic and resistive exercise, benefits persons with knee osteoarthritis, contributing to modest improvements in disability, physical performance, and pain (13)(14)(15)(16).…”

“…Participation in PA delays the onset of functional limitation (9,10), prevents obesity (11), and is essential for normal joint health (12,13). In addition, PA has been shown to reduce pain and disability among persons with arthritis and increase their physical performance and self efficacy (14,15). Yet, persons with arthritis often resist PA messages because activity may initially increase pain or because they were told, inappropriately, not to be physically active.…”

Long‐Term Exercise Therapy Resolves Ethnic Differences in Baseline Health Status in Older Adults with Knee Osteoarthritis

“…One group of researchers has written extensively on the role of self-efficacy beliefs in attenuating functional decline in older adults with knee pain and knee OA, finding in several investigations that self-efficacy accounted for 15% of the variance in performance, 32 that self-efficacy was enhanced through participation in aerobic and resistance exercise interventions, 33 and that participants who had low self-efficacy and low knee strength at baseline had the largest decline in self-reported disability and stair climb performance at 30 months. 13 Perhaps African-American participants' self-efficacy was enhanced to a greater degree than Caucasian Americans' through the exercise interventions.…”

Major public health benefits of physical activity

“…Physical activity decreases pain, improves self efficacy and physical function, and delays disability among persons with knee osteoarthritis (57,58). Regular physical activity does not seem to increase the progression (as observed by radiography) of osteoarthritis (59).…”