Physical Activity in Men and Women with Arthritis

National Health Interview Survey, 2002


      Regular physical activity in persons with arthritis has been shown to decrease pain, improve function, and delay disability. This study estimates the national prevalence of leisure-time physical activity and identifies factors associated with physical inactivity in adults with arthritis.


      Data from the 2002 National Health Interview Survey were analyzed in 2004–2005 to estimate the proportion of adults with arthritis meeting four physical activity recommendations put forward in Healthy People 2010 and one arthritis-specific recommendation established by a national expert panel in arthritis and physical activity. Multivariate logistic regression was used to evaluate the association between inactivity and sociodemographic factors, body mass index, functional limitations, social limitations, need for special equipment, frequent anxiety/depression, affected joint location, joint pain, physical activity counseling, and access to a fitness facility.


      Adults with arthritis were significantly less likely than adults without arthritis to engage in recommended levels of moderate or vigorous physical activity, and 37% of adults with arthritis were inactive. In both men and women with arthritis, inactivity was associated with older age, lower education, and having functional limitations; having access to a fitness facility was inversely associated with inactivity. Among women, inactivity was also associated with being Hispanic, non-Hispanic black, having frequent anxiety/depression or social limitations, needing special equipment, and not receiving physical activity counseling. Among men, inactivity was also associated with severe joint pain.


      Although physical activity is a recommended therapy for people with arthritis, levels among adults with arthritis are insufficient, and those with arthritis have worse activity profiles than their peers without arthritis. Efforts to promote physical activity should include expanding access to evidence-based interventions and recreational facilities/programs. The importance of physical activity counseling and associated pain management measures by healthcare providers should be emphasized.
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        • McNeil J.
        • Binette J.
        • Bureau of Census, U.S
        Department of Commerce, Centers for Disease Control and Prevention. Prevalence of disabilities and associated health conditions among adults—United States, 1999.
        MMWR Morb Mortal Wkly Rep. 2001; 50: 120-125
        • Bolen J.
        • Sniezek J.
        • Theis K.
        • et al.
        Racial/ethnic differences in the prevalence and impact of doctor-diagnosed arthritis—United States, 2002.
        MMWR Morb Mortal Wkly Rep. 2005; 54: 119-123
        • Yelin E.
        • Cisternas M.G.
        • Pasta D.J.
        • Trupin L.
        • Murphy L.
        • Helmick C.G.
        Medical care expenditures and earnings losses of persons with arthritis and other rheumatic conditions in the United States in 1997.
        Arthritis Rheum. 2004; 50: 2317-2326
        • Dunlop D.D.
        Risk factors for functional decline in older adults with arthritis.
        Arthritis Rheum. 2005; 52: 1274-1282
        • Wang G.
        • Helmick C.G.
        • Macera C.
        • Zhang P.
        • Pratt M.
        Inactivity-associated medical costs among U.S. adults with arthritis.
        Arthritis Rheum. 2001; 45: 439-445
        • Komatireddy G.R.
        • Leitch R.W.
        • Cella K.
        • Browning G.
        • Minor M.
        Efficacy of low load resistive muscle training in patients with rheumatoid arthritis functional class II and III.
        J Rheumatol. 1997; 24: 1531-1539
        • Thomas K.S.
        • Muir K.R.
        • Doherty M.
        • Jones A.C.
        • O’Reilly S.C.
        • Bassey E.J.
        Home-based exercise programme for knee pain and knee osteoarthritis.
        BMJ. 2002; 325: 752
        • Baker K.R.
        • Nelson M.E.
        • Felson D.T.
        • Layne J.E.
        • Sarno R.
        • Roubenoff R.
        The efficacy of home based progressive strength training in older adults with knee osteoarthritis.
        J Rheumatol. 2001; 28: 1655-1665
        • Fransen M.
        • Crosbie J.
        • Edmonds J.
        Physical therapy is effective for patients with osteoarthritis of the knee.
        J Rheumatol. 2001; 28: 156-164
        • Gur H.
        • Cakin N.
        • Akova B.
        • Okay E.
        • Kucukoglu S.
        Concentric versus combined concentric-eccentric isokinetic training.
        Arch Phys Med Rehabil. 2002; 83: 308-316
        • Maurer B.T.
        • Stern A.G.
        • Kinossian B.
        • Cook K.D.
        • Schumacher Jr, H.R.
        Osteoarthritis of the knee.
        Arch Phys Med Rehabil. 1999; 80: 1293-1299
        • O’Reilly S.C.
        • Muir K.R.
        • Doherty M.
        Effectiveness of home exercise on pain and disability from osteoarthritis of the knee.
        Ann Rheum Dis. 1999; 58: 15-19
        • Petrella R.J.
        • Bartha C.
        Home based exercise therapy for older patients with knee osteoarthritis.
        J Rheumatol. 2000; 27: 2215-2221
        • Hakkinen A.
        • Sokka T.
        • Kotaniemi A.
        • Hannonen P.
        A randomized two-year study of the effects of dynamic strength training on muscle strength, disease activity, functional capacity, and bone mineral density in early rheumatoid arthritis.
        Arthritis Rheum. 2001; 44: 515-522
        • Rogind H.
        • Bibow-Nielsen B.
        • Jensen B.
        • Moller H.C.
        • Frimodt-Moller H.
        • Bliddal H.
        The effects of a physical training program on patients with osteoarthritis of the knees.
        Arch Phys Med Rehabil. 1998; 79: 1421-1427
        • Ettinger Jr, W.H.
        • Burns R.
        • Messier S.P.
        • et al.
        A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST).
        JAMA. 1997; 277: 25-31
        • Schilke J.M.
        • Johnson G.O.
        • Housh T.J.
        • O’Dell J.R.
        Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint.
        Nurs Res. 1996; 45: 68-72
        • Rall L.C.
        • Meydani S.N.
        • Kehayias J.J.
        • Dawson-Hughes B.
        • Roubenoff R.
        The effect of progressive resistance training in rheumatoid arthritis. Increased strength without changes in energy balance or body composition.
        Arthritis Rheum. 1996; 39: 415-426
        • Wyatt F.B.
        • Milam S.
        • Manske R.C.
        • Deere R.
        The effects of aquatic and traditional exercise programs on persons with knee osteoarthritis.
        J Strength Cond Res. 2001; 15: 337-340
        • Hopman-Rock M.
        • Westhoff M.H.
        The effects of a health educational and exercise program for older adults with osteoarthritis for the hip or knee.
        J Rheumatol. 2000; 27: 1947-1954
        • van Baar M.E.
        • Assendelft W.J.
        • Dekker J.
        • Oostendorp R.A.
        • Bijlsma J.W.
        Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee.
        Arthritis Rheum. 1999; 42: 1361-1369
        • Penninx B.W.
        • Messier S.P.
        • Rejeski W.J.
        • et al.
        Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis.
        Arch Intern Med. 2001; 161: 2309-2316
        • Messier S.P.
        • Loeser R.F.
        • Miller G.D.
        • et al.
        Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis.
        Arthritis Rheum. 2004; 50: 1501-1510
        • Neuberger G.B.
        • Press A.N.
        • Lindsley H.B.
        • et al.
        Effects of exercise on fatigue, aerobic fitness, and disease activity measures in persons with rheumatoid arthritis.
        Res Nurs Health. 1997; 20: 195-204
        • Ekdahl C.
        • Andersson S.I.
        • Moritz U.
        • Svensson B.
        Dynamic versus static training in patients with rheumatoid arthritis.
        Scand J Rheumatol. 1990; 19: 17-26
        • van den Ende C.H.
        • Hazes J.M.
        • le Cessie S.
        • et al.
        Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results of a randomised clinical trial.
        Ann Rheum Dis. 1996; 55: 798-805
        • van den Ende C.H.
        • Breedveld F.C.
        • le Cessie S.
        • Dijkmans B.A.
        • de Mug A.W.
        • Hazes J.M.
        Effect of intensive exercise on patients with active rheumatoid arthritis.
        Ann Rheum Dis. 2000; 59: 615-621
        • Minor M.A.
        • Hewett J.E.
        • Webel R.R.
        • Anderson S.K.
        • Kay D.R.
        Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis.
        Arthritis Rheum. 1989; 32: 1396-1405
        • Kovar P.A.
        • Allegrante J.P.
        • MacKenzie C.R.
        • Peterson M.G.
        • Gutin B.
        • Charlson M.E.
        Supervised fitness walking in patients with osteoarthritis of the knee.
        Ann Intern Med. 1992; 116: 529-534
        • Mangione K.K.
        • McCully K.
        • Gloviak A.
        • Lefebvre I.
        • Hofmann M.
        • Craik R.
        The effects of high-intensity and low-intensity cycle ergometry in older adults with knee osteoarthritis.
        J Gerontol A Biol Sci Med Sci. 1999; 54: M184-M190
        • Westby M.D.
        A health professional’s guide to exercise prescription for people with arthritis.
        Arthritis Rheum. 2001; 45: 501-511
        • Busch A.
        • Schachter C.L.
        • Peloso P.M.
        • Bombardier C.
        Exercise for treating fibromyalgia syndrome.
        Cochrane Database Syst Rev. 2002; 3: CD003786
        • Tench C.M.
        • McCarthy J.
        • McCurdie I.
        • White P.D.
        • D’Cruz D.P.
        Fatigue in systemic lupus erythematosus.
        Rheumatology (Oxford). 2003; 42: 1050-1054
        • Hootman J.M.
        • Macera C.A.
        • Helmick C.G.
        • Blair S.N.
        Influence of physical activity-related joint stress on the risk of self-reported hip/knee osteoarthritis.
        Prev Med. 2003; 36: 636-644
        • de Jong Z.
        • Vlieland T.P.
        Safety of exercise in patients with rheumatoid arthritis.
        Curr Opin Rheumatol. 2005; 17: 177-182
        • Bruce D.G.
        • Devine A.
        • Prince R.L.
        Recreational physical activity levels in healthy older women.
        J Am Geriatr Soc. 2002; 50: 84-89
        • Finch C.
        • Owen N.
        • Price R.
        Current injury or disability as a barrier to being more physically active.
        Med Sci Sports Exerc. 2001; 33: 778-782
      1. Recommendations for the Management of Osteoarthritis of the Hip and Knee.
        Arthritis Rheum. 2000; 43: 1905-1915
      2. Guidelines for the Management of Rheumatoid Arthritis.
        Arthritis Rheum. 2002; 46: 328-346
        • U.S. Department of Health and Human Services
        Healthy People 2010. Understanding and improving health and objectives for improving health. 2nd ed. United States Government Printing Office, Washington DC2000
      3. Work group recommendations: 2002 Exercise and Physical Activity Conference, St. Louis, Missouri. Session V: evidence of benefit of exercise and physical activity in arthritis.
        Arthritis Rheum. 2003; 49: 453-454
      4. Design and estimation for the National Health Interview Survey, 1995–2004.
        Vital Health Stat 2. 2000; : 1-31
        • National Center for Health Statistics
        Data file documentation.
        ( Health Interview Survey, 2002 (machine-readable data file and documentation). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville MD2002
        • Hootman J.M.
        • Macera C.A.
        • Ham S.A.
        • Helmick C.G.
        • Sniezek J.E.
        Physical activity levels among the general U.S. adult population and in adults with and without arthritis.
        Arthritis Care Res. 2003; 49: 129-135
        • Fontaine K.R.
        • Heo M.
        • Bathon J.
        Are U.S. adults with arthritis meeting public health recommendations for physical activity?.
        Arthritis Rheum. 2004; 50: 624-628
        • Fontaine K.R.
        • Heo M.
        Changes in the prevalence of U.S. adults with arthritis who meet physical activity recommendations, 2001–2003.
        J Clin Rheum. 2005; 11: 13-16
        • Kaplan M.S.
        • Huguet N.
        • Newsom J.T.
        • McFarland B.H.
        Characteristics of physically inactive older adults with arthritis.
        Prev Med. 2003; 37: 61-67
        • Penninx B.W.
        • Rejeski W.J.
        • Pandya J.
        • et al.
        Exercise and depressive symptoms.
        J Gerontol B Psychol Sci Soc Sci. 2002; 57: 124-132
        • Roddy E.
        • Zhang W.
        • Doherty M.
        • et al.
        Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee—the MOVE consensus.
        Rheumatology. 2005; 44: 67-73
        • Seguin R.
        • Nelson M.E.
        The benefits of strength training for older adults.
        Am J Prev Med. 2003; 25: 141-149
        • Kruger J.
        • Brown D.
        • Galuska D.
        • Buchner D.
        Strength training among adults aged >65 years—United States, 2001.
        MMWR Morb Mortal Wkly Rep. 2004; 53: 25-28
        • Writing Group for the Activity Counseling Trial Research Group
        Effects of physical activity counseling in primary care: the Activity Counseling Trial: a randomized controlled trial.
        JAMA. 2001; 286: 677-687
        • Linzer M.
        • Spitzer R.
        • Kroenke K.
        • et al.
        Gender, quality of life, and mental disorders in primary care.
        Am J Med. 1996; 101: 526-533
        • Rapaport M.H.
        • Thompson P.M.
        • Kelsoe Jr, J.R.
        • Golshan S.
        • Judd L.L.
        • Gillin J.C.
        Gender differences in outpatient research subjects with affective disorders.
        J Clin Psychiatry. 1995; 56: 67-72
        • Verbrugge L.M.
        Gender and health.
        J Health Soc Behav. 1985; 26: 156-182
        • Lin E.H.
        • Katon W.
        • Von Korff M.
        • et al.
        Effect of improving depression care on pain and functional outcomes among older adults with arthritis.
        JAMA. 2003; 290: 2428-2429
        • Dickens C.
        • McGowan L.
        • Clark-Carter D.
        • Creed F.
        Depression in rheumatoid arthritis.
        Psychosom Med. 2002; 64: 52-60
        • el-Miedany Y.M.
        • el-Rasheed A.H.
        Is anxiety a more common disorder than depression in rheumatoid arthritis?.
        Joint Bone Spine. 2002; 69: 300-306
        • Wells K.B.
        • Stewart A.
        • Hays R.D.
        • et al.
        The functioning and well-being of depressed patients. Results from the Medical Outcomes Study.
        JAMA. 1989; 262: 914-919
        • van Gool C.H.
        • Penninx B.W.
        • Kempen G.I.
        • et al.
        Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis.
        Arthritis Rheum. 2005; 53: 24-32
        • Sacks J.J.
        • Harrold L.R.
        • Helmick C.G.
        • Gurwitz J.H.
        • Emani S.
        • Yood R.A.
        Validation of a surveillance case definition for arthritis.
        J Rheumatol. 2005; 32: 340-347
        • Bombard J.M.
        • Powell K.E.
        • Martin M.L.
        • Helmick C.G.
        • Wilson W.H.
        Validity and reliability of self-reported arthritis, Georgia senior citizens, 2000–2001.
        Am J Prev Med. 2005; 28: 251-258
        • Strath S.J.
        • Bassett Jr, D.R.
        • Ham S.A.
        • Swartz A.M.
        Assessment of physical activity by telephone interview versus objective monitoring.
        Med Sci Sports Exerc. 2003; 35: 2112-2118
        • Brady T.J.
        • Kruger J.
        • Helmick C.G.
        • Callahan L.F.
        • Boutaugh M.L.
        Intervention programs for arthritis and other rheumatic diseases.
        Health Educ Behav. 2003; 30: 44-63
        • Task Force on Community Preventive Services
        Recommendations to increase physical activity in communities.
        Am J Prev Med. 2002; 22: 67-72
        • King A.C.
        • Haskell W.L.
        • Taylor C.B.
        • Kraemer H.C.
        • DeBusk R.F.
        Group- vs home-based exercise training in healthy older men and women. A community-based clinical trial.
        JAMA. 1991; 266: 1535-1542
        • Fransen M.
        • McConnell S.
        • Bell M.
        Exercise for osteoarthritis of the hip or knee.
        Cochrane Database Syst Rev. 2003; 3: CD004286
        • Mili F.
        • Helmick C.G.
        • Moriarty D.G.
        Health-related quality of life among adults reporting arthritis.
        J Rheumatol. 2003; 30: 160-166
        • Hootman J.
        • Helmick C.
        • Langmaid G.
        Public health and aging.
        MMWR Morb Mortal Wkly Rep. 2003; 52: 489-491
        • U.S. Department of Health and Human Services
        Physical activity and health. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta GA1996