Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

Physical activity status by pain severity in patients with knee osteoarthritis: a nationwide study in Korea

Authors: Hye-Young Shim, Mira Park, Hee-June Kim, Hee-Soo Kyung, Ji-Yeon Shin

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

Login to get access

Abstract

Backgrounds

Few reports have explored the extent to which physical activity is affected by pain severity in knee osteoarthritis (KOA) patients. We used national representative data to investigate the physical activity of KOA patients compared to the general population to determine what proportion of patients met physical activity recommendations and to explore how the proportion changes with pain severity.

Methods

We used data from the fifth Korean National Health and Nutrition Examination Survey (KNHANES V; 2010–2012). In total, 1279 participants aged ≥50 years who had radiographic KOA and who evaluated knee pain on a numerical rating scale were selected. KOA was assessed using the Kellgren–Lawrence system. The Korean short version of the International Physical Activity Questionnaire was used to measure physical activity status. We used the physical activity recommendations of the American College of Rheumatology Work Group Panel when evaluating the extent of activity in KOA patients.

Results

Only 18.6% of KOA patients met the osteoarthritis expert panel recommendations, lower than in the general population (23.2%; p = 0.003). The percentages that met the recommendations in the none to mild pain group, moderate pain group, and severe pain group were 23.4%, 17.6%, and 18.3%, respectively (p = 0.341). In terms of flexibility, a somewhat higher percentage of those with moderate pain engaged in physical activity compared to those with little or no pain (17.1% vs. 12.3%), but the difference was not significant (p = 0.585).

Conclusions

Regardless of pain severity, overall physical activity was suboptimal in Korean KOA patients. It is important to emphasize to osteoarthritis patients in clinical settings the need for physical activity, and a policy-based effort is required to facilitate appropriate exercise.
Appendix
Available only for authorised users
Literature
1.
go back to reference Breedveld F. Osteoarthritis—the impact of a serious disease. Rheumatology (Oxford). 2004;43(suppl_1):i4–8.CrossRef Breedveld F. Osteoarthritis—the impact of a serious disease. Rheumatology (Oxford). 2004;43(suppl_1):i4–8.CrossRef
3.
go back to reference Lee HS. Prevalence of osteoarthritis and related risk factors in the elderly: data from the fifth Korea National Health and nutrition examination survey (KNHANES V), 2010~ 2012. J Korean Diet Assoc. 2014;20(2):99–109.CrossRef Lee HS. Prevalence of osteoarthritis and related risk factors in the elderly: data from the fifth Korea National Health and nutrition examination survey (KNHANES V), 2010~ 2012. J Korean Diet Assoc. 2014;20(2):99–109.CrossRef
4.
go back to reference Yang S, An J. Health status, health behavior and quality of life in the elderly with osteoarthritis. Nurs Sci. 2011;23(2):23–33. Yang S, An J. Health status, health behavior and quality of life in the elderly with osteoarthritis. Nurs Sci. 2011;23(2):23–33.
5.
go back to reference Hartman CA, Manos TM, Winter C, Hartman DM, Li B, Smith JC. Effects of T’ai Chi training on function and quality of life indicators in older adults with osteoarthritis. J Am Geriatr Soc. 2000;48(12):1553–9.CrossRef Hartman CA, Manos TM, Winter C, Hartman DM, Li B, Smith JC. Effects of T’ai Chi training on function and quality of life indicators in older adults with osteoarthritis. J Am Geriatr Soc. 2000;48(12):1553–9.CrossRef
7.
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):622–36.CrossRef 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):622–36.CrossRef
8.
go back to reference McAlindon TE, Bannuru RR, Sullivan M, Arden N, Berenbaum F, Bierma-Zeinstra S, Hawker G, Henrotin Y, Hunter D, Kawaguchi H. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil. 2014;22(3):363–88.CrossRef McAlindon TE, Bannuru RR, Sullivan M, Arden N, Berenbaum F, Bierma-Zeinstra S, Hawker G, Henrotin Y, Hunter D, Kawaguchi H. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil. 2014;22(3):363–88.CrossRef
9.
go back to reference Jevsevar DS, Brown GA, Jones DL, Matzkin EG, Manner PA, Mooar P, Schousboe JT, Stovitz S, Sanders JO, Bozic KJ. The American Academy of Orthopaedic surgeons evidence-based guideline on: treatment of osteoarthritis of the knee. J Bone Joint Surg. 2013;95(20):1885–6.CrossRef Jevsevar DS, Brown GA, Jones DL, Matzkin EG, Manner PA, Mooar P, Schousboe JT, Stovitz S, Sanders JO, Bozic KJ. The American Academy of Orthopaedic surgeons evidence-based guideline on: treatment of osteoarthritis of the knee. J Bone Joint Surg. 2013;95(20):1885–6.CrossRef
10.
go back to reference McGibbon CA. Work group recommendations: 2002 exercise and physical activity conference, St. Louis, Missouri. Arthritis Rheum. 2003;49(2):261–2.CrossRef McGibbon CA. Work group recommendations: 2002 exercise and physical activity conference, St. Louis, Missouri. Arthritis Rheum. 2003;49(2):261–2.CrossRef
11.
go back to reference Lundebjerg N. Exercise prescription for older adults with osteoarthritis pain: consensus practice recommendations. J Am Geriatr Soc. 2001;49(6):808–23.CrossRef Lundebjerg N. Exercise prescription for older adults with osteoarthritis pain: consensus practice recommendations. J Am Geriatr Soc. 2001;49(6):808–23.CrossRef
12.
go back to reference Korean Knee Society Subcommittee on Osteoarthritis Guidelines. Guidelines for the treatment of osteoarthritis of the knee, Korean knee society subcommittee on osteoarthritis guidelines. J Korean Knee Soc. 2010;22(1):69–74. Korean Knee Society Subcommittee on Osteoarthritis Guidelines. Guidelines for the treatment of osteoarthritis of the knee, Korean knee society subcommittee on osteoarthritis guidelines. J Korean Knee Soc. 2010;22(1):69–74.
13.
go back to reference Wallis J, Webster K, Levinger P, Taylor N. What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis. Osteoarthr Cartil. 2013;21(11):1648–59.CrossRef Wallis J, Webster K, Levinger P, Taylor N. What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis. Osteoarthr Cartil. 2013;21(11):1648–59.CrossRef
14.
go back to reference Rahman MM, Kopec JA, Anis AH, Cibere J, Goldsmith CH. Risk of cardiovascular disease in patients with osteoarthritis: a prospective longitudinal study. Arthritis Care Res (Hoboken). 2013;65(12):1951–8.CrossRef Rahman MM, Kopec JA, Anis AH, Cibere J, Goldsmith CH. Risk of cardiovascular disease in patients with osteoarthritis: a prospective longitudinal study. Arthritis Care Res (Hoboken). 2013;65(12):1951–8.CrossRef
15.
go back to reference Dekker J, Boot B, van der Woude LH, Bijlsma J. Pain and disability in osteoarthritis: a review of biobehavioral mechanisms. J Behav Med. 1992;15(2):189–214.CrossRef Dekker J, Boot B, van der Woude LH, Bijlsma J. Pain and disability in osteoarthritis: a review of biobehavioral mechanisms. J Behav Med. 1992;15(2):189–214.CrossRef
16.
go back to reference Yoon YS, Choi HS, Kim JK, Kim YI, Oh SW. Differences in the associations of anthropometric measures with insulin resistance and type 2 diabetes mellitus between Korean and US populations: comparisons of representative nationwide sample data. Obes Res Clin Pract. 2016;10(6):642–51.CrossRef Yoon YS, Choi HS, Kim JK, Kim YI, Oh SW. Differences in the associations of anthropometric measures with insulin resistance and type 2 diabetes mellitus between Korean and US populations: comparisons of representative nationwide sample data. Obes Res Clin Pract. 2016;10(6):642–51.CrossRef
17.
go back to reference Ha JK, Kim JG, Lee MC, Wang JH, Research Committee for Development of a Novel Knee Evaluation System of Korean Knee Society. What symptoms are more important for Korean patients in knee osteoarthritis? Development and validation of the Korean knee score. Knee Surg Relat Res. 2012;24(3):151–7.CrossRef Ha JK, Kim JG, Lee MC, Wang JH, Research Committee for Development of a Novel Knee Evaluation System of Korean Knee Society. What symptoms are more important for Korean patients in knee osteoarthritis? Development and validation of the Korean knee score. Knee Surg Relat Res. 2012;24(3):151–7.CrossRef
18.
go back to reference Kweon S, Kim Y, Jang M-j, Kim Y, Kim K, Choi S, Chun C, Khang Y-H, Oh K. Data resource profile: the Korea national health and nutrition examination survey (KNHANES). Int J Epidemiol. 2014;43(1):69–77.CrossRef Kweon S, Kim Y, Jang M-j, Kim Y, Kim K, Choi S, Chun C, Khang Y-H, Oh K. Data resource profile: the Korea national health and nutrition examination survey (KNHANES). Int J Epidemiol. 2014;43(1):69–77.CrossRef
19.
go back to reference Kim Y. The Korea National Health and nutrition examination survey (KNHANES): current status and challenges. Epidemiol Health. 2014;36:e2014002.CrossRef Kim Y. The Korea National Health and nutrition examination survey (KNHANES): current status and challenges. Epidemiol Health. 2014;36:e2014002.CrossRef
20.
go back to reference Kellgren J, Lawrence J. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.CrossRef Kellgren J, Lawrence J. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.CrossRef
21.
go back to reference Lee S, Kim SJ. Prevalence of knee osteoarthritis, risk factors, and quality of life: the fifth Korean National Health and nutrition examination survey. Int J Rheum Dis. 2015;20(7):809–17.CrossRef Lee S, Kim SJ. Prevalence of knee osteoarthritis, risk factors, and quality of life: the fifth Korean National Health and nutrition examination survey. Int J Rheum Dis. 2015;20(7):809–17.CrossRef
22.
go back to reference Korea Centers for Disease Control and Prevention. Korea National Health and nutrition examination survey V, the third year (2012): professional surveyor education and quality control for osteoarthritis examination. Seoul: Korea Centers for Disease Control and Prevention; 2012. Korea Centers for Disease Control and Prevention. Korea National Health and nutrition examination survey V, the third year (2012): professional surveyor education and quality control for osteoarthritis examination. Seoul: Korea Centers for Disease Control and Prevention; 2012.
23.
go back to reference Shih M, Hootman JM, Kruger J, Helmick CG. Physical activity in men and women with arthritis: National Health Interview Survey, 2002. Am J Prev Med. 2006;30(5):385–93.CrossRef Shih M, Hootman JM, Kruger J, Helmick CG. Physical activity in men and women with arthritis: National Health Interview Survey, 2002. Am J Prev Med. 2006;30(5):385–93.CrossRef
24.
go back to reference Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of international physical activity questionnaire (IPAQ) short form. J Korean Acad Fam Med. 2007;28(7):532–41. Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of international physical activity questionnaire (IPAQ) short form. J Korean Acad Fam Med. 2007;28(7):532–41.
25.
go back to reference International Physical Activity Questionnaire Research Committee: Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)–short and long forms. 2005. http://www.ipaq.ki.se/. Accessed 30 Aug 2017. International Physical Activity Questionnaire Research Committee: Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)–short and long forms. 2005. http://​www.​ipaq.​ki.​se/​. Accessed 30 Aug 2017.
26.
go back to reference Zheng W, McLerran DF, Rolland B, Zhang X, Inoue M, Matsuo K, He J, Gupta PC, Ramadas K, Tsugane S. Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med. 2011;364(8):719–29.CrossRef Zheng W, McLerran DF, Rolland B, Zhang X, Inoue M, Matsuo K, He J, Gupta PC, Ramadas K, Tsugane S. Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med. 2011;364(8):719–29.CrossRef
27.
go back to reference Kang K, Sung J, Kim CY. High risk groups in health behavior defined by clustering of smoking, alcohol, and exercise habits: National Health and nutrition examination survey. J Prev Med Public Health. 2010;43(1):73–81.CrossRef Kang K, Sung J, Kim CY. High risk groups in health behavior defined by clustering of smoking, alcohol, and exercise habits: National Health and nutrition examination survey. J Prev Med Public Health. 2010;43(1):73–81.CrossRef
28.
go back to reference Dunlop DD, Song J, Semanik PA, Chang RW, Sharma L, Bathon JM, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK. Objective physical activity measurement in the osteoarthritis initiative: are guidelines being met? Arthritis Rheum. 2011;63(11):3372–82.CrossRef Dunlop DD, Song J, Semanik PA, Chang RW, Sharma L, Bathon JM, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK. Objective physical activity measurement in the osteoarthritis initiative: are guidelines being met? Arthritis Rheum. 2011;63(11):3372–82.CrossRef
29.
go back to reference Rosemann T, Kuehlein T, Laux G, Szecsenyi J. Factors associated with physical activity of patients with osteoarthritis of the lower limb. J Eval Clin Pract. 2008;14(2):288–93.CrossRef Rosemann T, Kuehlein T, Laux G, Szecsenyi J. Factors associated with physical activity of patients with osteoarthritis of the lower limb. J Eval Clin Pract. 2008;14(2):288–93.CrossRef
30.
go back to reference Somers TJ, Keefe FJ, Pells JJ, Dixon KE, Waters SJ, Riordan PA, Blumenthal JA, McKee DC, LaCaille L, Tucker JM. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manag. 2009;37(5):863–72.CrossRef Somers TJ, Keefe FJ, Pells JJ, Dixon KE, Waters SJ, Riordan PA, Blumenthal JA, McKee DC, LaCaille L, Tucker JM. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manag. 2009;37(5):863–72.CrossRef
31.
go back to reference Steultjens M, Dekker J, Bijlsma J. Avoidance of activity and disability in patients with osteoarthritis of the knee: the mediating role of muscle strength. Arthritis Rheum. 2002;46(7):1784–8.CrossRef Steultjens M, Dekker J, Bijlsma J. Avoidance of activity and disability in patients with osteoarthritis of the knee: the mediating role of muscle strength. Arthritis Rheum. 2002;46(7):1784–8.CrossRef
32.
go back to reference White DK, Tudor-Locke C, Felson DT, Gross KD, Niu J, Nevitt M, Lewis CE, Torner J, Neogi T. Do radiographic disease and pain account for why people with or at high risk of knee osteoarthritis do not meet physical activity guidelines? Arthritis Rheum. 2013;65(1):139–47.CrossRef White DK, Tudor-Locke C, Felson DT, Gross KD, Niu J, Nevitt M, Lewis CE, Torner J, Neogi T. Do radiographic disease and pain account for why people with or at high risk of knee osteoarthritis do not meet physical activity guidelines? Arthritis Rheum. 2013;65(1):139–47.CrossRef
33.
go back to reference Dunlop DD, Song J, Semanik PA, Sharma L, Chang RW. Physical activity levels and functional performance in the osteoarthritis initiative: a graded relationship. Arthritis Rheum. 2011;63(1):127–36.CrossRef Dunlop DD, Song J, Semanik PA, Sharma L, Chang RW. Physical activity levels and functional performance in the osteoarthritis initiative: a graded relationship. Arthritis Rheum. 2011;63(1):127–36.CrossRef
34.
go back to reference De Groot I, Bussmann J, Stam H, Verhaar J. Actual everyday physical activity in patients with end-stage hip or knee osteoarthritis compared with healthy controls. Osteoarthr Cartil. 2008;16(4):436–42.CrossRef De Groot I, Bussmann J, Stam H, Verhaar J. Actual everyday physical activity in patients with end-stage hip or knee osteoarthritis compared with healthy controls. Osteoarthr Cartil. 2008;16(4):436–42.CrossRef
35.
go back to reference Farr JN, Going SB, Lohman TG, Rankin L, Kasle S, Cornett M, Cussler E. Physical activity levels in patients with early knee osteoarthritis measured by accelerometry. Arthritis Care Res (Hoboken). 2008;59(9):1229–36.CrossRef Farr JN, Going SB, Lohman TG, Rankin L, Kasle S, Cornett M, Cussler E. Physical activity levels in patients with early knee osteoarthritis measured by accelerometry. Arthritis Care Res (Hoboken). 2008;59(9):1229–36.CrossRef
36.
go back to reference Vaishya R, Pariyo GB, Agarwal AK, Vijay V. Non-operative management of osteoarthritis of the knee joint. J Clin Orthop Trauma. 2016;7(3):170–6.CrossRef Vaishya R, Pariyo GB, Agarwal AK, Vijay V. Non-operative management of osteoarthritis of the knee joint. J Clin Orthop Trauma. 2016;7(3):170–6.CrossRef
37.
go back to reference Feuerstein JD, Pelsis JR, Lloyd S, Cheifetz AS, Stone KR. Systematic analysis of the quality of the scientific evidence and conflicts of interest in osteoarthritis of the hip and knee practice guidelines. Semin Arthritis Rheum. 2016;45:379–85 Elsevier.CrossRef Feuerstein JD, Pelsis JR, Lloyd S, Cheifetz AS, Stone KR. Systematic analysis of the quality of the scientific evidence and conflicts of interest in osteoarthritis of the hip and knee practice guidelines. Semin Arthritis Rheum. 2016;45:379–85 Elsevier.CrossRef
38.
go back to reference Veenhof C, Huisman P, Barten J, Takken T, Pisters M. Factors associated with physical activity in patients with osteoarthritis of the hip or knee: a systematic review. Osteoarthr Cartil. 2012;20(1):6–12.CrossRef Veenhof C, Huisman P, Barten J, Takken T, Pisters M. Factors associated with physical activity in patients with osteoarthritis of the hip or knee: a systematic review. Osteoarthr Cartil. 2012;20(1):6–12.CrossRef
Metadata
Title
Physical activity status by pain severity in patients with knee osteoarthritis: a nationwide study in Korea
Authors
Hye-Young Shim
Mira Park
Hee-June Kim
Hee-Soo Kyung
Ji-Yeon Shin
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-2301-6

Other articles of this Issue 1/2018

BMC Musculoskeletal Disorders 1/2018 Go to the issue