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Published in: BMC Public Health 1/2021

Open Access 01-12-2021 | Joint Pain | Research article

The effects of race/ethnicity and physician recommendation for physical activity on physical activity levels and arthritis symptoms among adults with arthritis

Authors: Jeremy Huckleby, Faustine Williams, Rose Ramos, Anna María Nápoles

Published in: BMC Public Health | Issue 1/2021

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Abstract

Background

Among U.S. adults with physician-diagnosed arthritis, we examined the association of 1) participant race/ethnicity with meeting physical activity guidelines and arthritis symptoms, and 2) the association of receipt of a physician exercise recommendation with physical activity levels and arthritis symptoms, and whether race/ethnicity moderates these associations.

Methods

Retrospective, cross-sectional study of National Health Interview Survey pooled data from 2002, 2006, 2009, and 2014 from 27,887 U.S. adults aged ≥18 years with arthritis. Outcomes were meeting aerobic (yes/no) and strengthening guidelines (yes/no), arthritis-associated activity limitations (yes/no) and arthritis-related pain (0–10; higher score = more pain). Predictors were race/ethnicity (White, African American, Latino, and Asian) and receipt of physician recommendation for exercise (yes/no). Covariates included demographic and health characteristics.

Results

Adjusting for covariates, African Americans were more likely (AOR = 1.27; 95% CI 1.12, 1.43) and Asians were less likely (AOR = 0.75; 95% CI 0.61, 0.92) than Whites to meet muscle strengthening activity guidelines. Compared to Whites, African Americans (B = 0.48; 95% CI 0.24, 0.72) and Latinos (B = 0.44; 95% CI 0.15, 0.72) reported more severe, while Asians reported less severe (B = -0.68; 95% CI -1.22, − 0.14) joint pain. Controlling for covariates, physician exercise recommendation was associated with meeting aerobic (AOR = 1.20; 95% CI 1.11, 1.30) and strengthening (AOR = 1.21; 95% CI 1.11, 1.33) guidelines, regardless of race/ethnicity except for a weak negative association with meeting strengthening guidelines (AOR = 0.85; CI 0.74–0.99) among Latinos.

Conclusions

Disparities in pain exist for African Americans and Latinos with arthritis. Physician exercise recommendation is critical among patients with arthritis to relieve symptom burden.
Literature
1.
go back to reference Barbour KE, Helmick CG, Boring M, Brady TJ. Vital Signs: Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation - United States, 2013–2015. MMWR Morb Mortal Wkly Rep. 2017;66(9):246–253. Epub 2017/03/10. doi: https://doi.org/10.15585/mmwr.mm6609e1. PubMed PMID: 28278145; PubMed Central PMCID: PMCPMC5687192. Barbour KE, Helmick CG, Boring M, Brady TJ. Vital Signs: Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation - United States, 2013–2015. MMWR Morb Mortal Wkly Rep. 2017;66(9):246–253. Epub 2017/03/10. doi: https://​doi.​org/​10.​15585/​mmwr.​mm6609e1. PubMed PMID: 28278145; PubMed Central PMCID: PMCPMC5687192.
2.
go back to reference Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA. Updated projected prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation among US adults, 2015–2040. Arthritis Rheumatol. 2016;68(7):1582–1587. Epub 2016/03/26. doi: https://doi.org/10.1002/art.39692. PubMed PMID: 27015600; PubMed Central PMCID: PMCPMC6059375. Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA. Updated projected prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation among US adults, 2015–2040. Arthritis Rheumatol. 2016;68(7):1582–1587. Epub 2016/03/26. doi: https://​doi.​org/​10.​1002/​art.​39692. PubMed PMID: 27015600; PubMed Central PMCID: PMCPMC6059375.
4.
go back to reference Carlson VR, Ong AC, Orozco FR, Hernandez VH, Lutz RW, Post ZD. Compliance sith the AAOS guidelines for treatment of osteoarthritis of the knee: a survey of the American Association of hip and Knee Surgeons. J Am Acad Orthop Surg 2018;26(3):103–107. Epub 2017/12/29. doi: https://doi.org/10.5435/jaaos-d-17-00164. PubMed PMID: 29283898. Carlson VR, Ong AC, Orozco FR, Hernandez VH, Lutz RW, Post ZD. Compliance sith the AAOS guidelines for treatment of osteoarthritis of the knee: a survey of the American Association of hip and Knee Surgeons. J Am Acad Orthop Surg 2018;26(3):103–107. Epub 2017/12/29. doi: https://​doi.​org/​10.​5435/​jaaos-d-17-00164. PubMed PMID: 29283898.
6.
go back to reference Bartholdy C, Juhl C, Christensen R, Lund H, Zhang W, Henriksen M. The role of muscle strengthening in exercise therapy for knee osteoarthritis: a systematic review and meta-regression analysis of randomized trials. Semin Arthritis Rheum 2017;47(1):9–21. Epub 2017/04/26. doi: https://doi.org/10.1016/j.semarthrit.2017.03.007. PubMed PMID: 28438380. Bartholdy C, Juhl C, Christensen R, Lund H, Zhang W, Henriksen M. The role of muscle strengthening in exercise therapy for knee osteoarthritis: a systematic review and meta-regression analysis of randomized trials. Semin Arthritis Rheum 2017;47(1):9–21. Epub 2017/04/26. doi: https://​doi.​org/​10.​1016/​j.​semarthrit.​2017.​03.​007. PubMed PMID: 28438380.
7.
go back to reference Roddy E, Zhang W, Doherty M. Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Ann Rheum Dis. 2005;64(4):544–548. Epub 2005/03/17. doi: https://doi.org/10.1136/ard.2004.028746. PubMed PMID: 15769914; PubMed Central PMCID: PMCPMC1755453. Roddy E, Zhang W, Doherty M. Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Ann Rheum Dis. 2005;64(4):544–548. Epub 2005/03/17. doi: https://​doi.​org/​10.​1136/​ard.​2004.​028746. PubMed PMID: 15769914; PubMed Central PMCID: PMCPMC1755453.
8.
go back to reference Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PLoS One. 2017;12(6):e0178621. Epub 2017/06/24. doi: https://doi.org/10.1371/journal.pone.0178621. PubMed PMID: 28640822; PubMed Central PMCID: PMCPMC5480856. Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PLoS One. 2017;12(6):e0178621. Epub 2017/06/24. doi: https://​doi.​org/​10.​1371/​journal.​pone.​0178621. PubMed PMID: 28640822; PubMed Central PMCID: PMCPMC5480856.
9.
go back to reference Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;4:Cd011279. Epub 2017/04/25. doi: https://doi.org/10.1002/14651858.CD011279.pub3. PubMed PMID: 28436583; PubMed Central PMCID: PMCPMC5461882. Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;4:Cd011279. Epub 2017/04/25. doi: https://​doi.​org/​10.​1002/​14651858.​CD011279.​pub3. PubMed PMID: 28436583; PubMed Central PMCID: PMCPMC5461882.
11.
go back to reference Tanaka R, Ozawa J, Kito N, Moriyama H. Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2013;27(12):1059–1071. Epub 2013/07/06. doi: https://doi.org/10.1177/0269215513488898. PubMed PMID: 23828186. Tanaka R, Ozawa J, Kito N, Moriyama H. Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2013;27(12):1059–1071. Epub 2013/07/06. doi: https://​doi.​org/​10.​1177/​0269215513488898​. PubMed PMID: 23828186.
12.
go back to reference Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the U.S. bone and joint initiative. Semin Arthritis Rheum 2014;43(6):701–712. Epub 2014/01/07. doi: https://doi.org/10.1016/j.semarthrit.2013.11.012. PubMed PMID: 24387819. Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the U.S. bone and joint initiative. Semin Arthritis Rheum 2014;43(6):701–712. Epub 2014/01/07. doi: https://​doi.​org/​10.​1016/​j.​semarthrit.​2013.​11.​012. PubMed PMID: 24387819.
13.
go back to reference Hootman JM, Macera CA, Ham SA, Helmick CG, Sniezek JE. Physical activity levels among the general US adult population and in adults with and without arthritis. Arthritis Rheum 2003;49(1):129–135. Epub 2003/02/13. doi: https://doi.org/10.1002/art.10911. PubMed PMID: 12579604. Hootman JM, Macera CA, Ham SA, Helmick CG, Sniezek JE. Physical activity levels among the general US adult population and in adults with and without arthritis. Arthritis Rheum 2003;49(1):129–135. Epub 2003/02/13. doi: https://​doi.​org/​10.​1002/​art.​10911. PubMed PMID: 12579604.
15.
go back to reference Song J, Hochberg MC, Chang RW, et al. Racial and ethnic differences in physical activity guidelines attainment among people at high risk of or having knee osteoarthritis. Arthritis Care Res (Hoboken). 2013;65(2):195–202. Epub 2012/07/19. doi: https://doi.org/10.1002/acr.21803. PubMed PMID: 22807352; PubMed Central PMCID: PMCPMC3502693. Song J, Hochberg MC, Chang RW, et al. Racial and ethnic differences in physical activity guidelines attainment among people at high risk of or having knee osteoarthritis. Arthritis Care Res (Hoboken). 2013;65(2):195–202. Epub 2012/07/19. doi: https://​doi.​org/​10.​1002/​acr.​21803. PubMed PMID: 22807352; PubMed Central PMCID: PMCPMC3502693.
16.
go back to reference Austin S, Qu H, Shewchuk RM. Health care providers' recommendations for physical activity and adherence to physical activity guidelines among adults with arthritis. Prev Chronic Dis. 2013;10:E182. Epub 2013/11/10. doi: https://doi.org/10.5888/pcd10.130077. PubMed PMID: 24199735; PubMed Central PMCID: PMCPMC3820529. Austin S, Qu H, Shewchuk RM. Health care providers' recommendations for physical activity and adherence to physical activity guidelines among adults with arthritis. Prev Chronic Dis. 2013;10:E182. Epub 2013/11/10. doi: https://​doi.​org/​10.​5888/​pcd10.​130077. PubMed PMID: 24199735; PubMed Central PMCID: PMCPMC3820529.
17.
go back to reference Austin S, Saag KG, Pisu M. Healthcare Providers' recommendations for physical activity among US arthritis population: A cross-sectional analysis by race/ethnicity. Arthritis. 2018;2018:2807035. Epub 2018/03/15. doi: https://doi.org/10.1155/2018/2807035. PubMed PMID: 29535871; PubMed Central PMCID: PMCPMC5817278. Austin S, Saag KG, Pisu M. Healthcare Providers' recommendations for physical activity among US arthritis population: A cross-sectional analysis by race/ethnicity. Arthritis. 2018;2018:2807035. Epub 2018/03/15. doi: https://​doi.​org/​10.​1155/​2018/​2807035. PubMed PMID: 29535871; PubMed Central PMCID: PMCPMC5817278.
19.
go back to reference Juhl C, Christensen R, Roos EM, Zhang W, Lund H. Impact of exercise type and dose on pain and disability in knee osteoarthritis: a systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheumatol 2014;66(3):622–636. Epub 2014/02/28. doi: https://doi.org/10.1002/art.38290. PubMed PMID: 24574223. Juhl C, Christensen R, Roos EM, Zhang W, Lund H. Impact of exercise type and dose on pain and disability in knee osteoarthritis: a systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheumatol 2014;66(3):622–636. Epub 2014/02/28. doi: https://​doi.​org/​10.​1002/​art.​38290. PubMed PMID: 24574223.
21.
go back to reference Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand SLT, Manderscheid RW, Walters EE, Zaslavsky AM Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003;60(2):184–189. Epub 2003/02/13. doi: https://doi.org/10.1001/archpsyc.60.2.184. PubMed PMID: 12578436. Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand SLT, Manderscheid RW, Walters EE, Zaslavsky AM Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003;60(2):184–189. Epub 2003/02/13. doi: https://​doi.​org/​10.​1001/​archpsyc.​60.​2.​184. PubMed PMID: 12578436.
23.
go back to reference Tomitaka S, Kawasaki Y, Ide K, et al. Characteristic distribution of the total and individual item scores on the Kessler Screening Scale for Psychological Distress (K6) in US adults. BMC Psychiatry. 2017;17(1):290. Epub 2017/08/09. doi: https://doi.org/10.1186/s12888-017-1449-1. PubMed PMID: 28784101; PubMed Central PMCID: PMCPMC5545851. Tomitaka S, Kawasaki Y, Ide K, et al. Characteristic distribution of the total and individual item scores on the Kessler Screening Scale for Psychological Distress (K6) in US adults. BMC Psychiatry. 2017;17(1):290. Epub 2017/08/09. doi: https://​doi.​org/​10.​1186/​s12888-017-1449-1. PubMed PMID: 28784101; PubMed Central PMCID: PMCPMC5545851.
25.
go back to reference Kinnett-Hopkins D, Motl R. Preferences for exercise among black individuals with multiple sclerosis. Mult Scler J Exp Transl Clin. 2019;5(1):2055217319834715. Epub 2019/03/13. doi: https://doi.org/10.1177/2055217319834715. PubMed PMID: 30858982; PubMed Central PMCID: PMCPMC6402065. Kinnett-Hopkins D, Motl R. Preferences for exercise among black individuals with multiple sclerosis. Mult Scler J Exp Transl Clin. 2019;5(1):2055217319834715. Epub 2019/03/13. doi: https://​doi.​org/​10.​1177/​2055217319834715​. PubMed PMID: 30858982; PubMed Central PMCID: PMCPMC6402065.
26.
go back to reference Bolen J. Differences in the prevalence and impact of arthritis among racial/ethnic groups in the United States, National Health Interview Survey. Prev Chronic Dis. 2010;7(3). Bolen J. Differences in the prevalence and impact of arthritis among racial/ethnic groups in the United States, National Health Interview Survey. Prev Chronic Dis. 2010;7(3).
33.
go back to reference Murphy LB, Cisternas MG, Pasta DJ, Helmick CG, Yelin EH. Medical expenditures and earnings losses among US adults with arthritis in 2013. Arthritis Care Res (Hoboken) 2018;70(6):869–876. Epub 2017/09/28. doi: https://doi.org/10.1002/acr.23425. PubMed PMID: 28950426. Murphy LB, Cisternas MG, Pasta DJ, Helmick CG, Yelin EH. Medical expenditures and earnings losses among US adults with arthritis in 2013. Arthritis Care Res (Hoboken) 2018;70(6):869–876. Epub 2017/09/28. doi: https://​doi.​org/​10.​1002/​acr.​23425. PubMed PMID: 28950426.
Metadata
Title
The effects of race/ethnicity and physician recommendation for physical activity on physical activity levels and arthritis symptoms among adults with arthritis
Authors
Jeremy Huckleby
Faustine Williams
Rose Ramos
Anna María Nápoles
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-021-11570-6

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