New study aims to improve analysis of physical activity in osteoarthritis patients (published on 16 May 2017)

The scientific assessment of physical activity trends in people with osteoarthritis could be enhanced thanks to a new study funded by Versus Arthritis.

Led by the Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis at the University of Oxford, the study looked at reporting methods of physical activity across a number of international studies, before making a series of recommendations about how these methods could be made more consistent.

Forming a clearer consensus

Researchers are becoming increasingly aware that physical activity needs to be considered an important factor when studying osteoarthritis, but methods of assessing exercise levels are generally highly variable and have not been developed for use within scientific studies.

Since this creates difficulties when comparing and interpreting data across different pieces of research, the aim of this study - published in the journal Rheumatology International - was to to establish an expert consensus on the most appropriate methods.

After speaking to an expert panel, a number of recommendations were outlined.

These included emphasising the need for all parameters of a given activity - including duration, frequency, type and intensity to be given within a specified timeframe, while physical activity should be measured across all domains of daily life, including not just dedicated sport and leisure time, but also household chores or gardening, active travel, and occupational activity.

Efforts also need to be made to better account for the effect of job-related physical work on osteoarthritis risk, while a consistent system of measuring joint loading for each reported activity is required.

What benefits will this study deliver?

It is hoped that by establishing these guidelines, it will be easier for researchers to compare and contrast their osteoarthritis study findings in future, leading to a higher quality of scientific insight.

The researchers concluded: "The application of these recommendations in future individual patient meta-analysis on physical activity and osteoarthritis will provide a homogeneous way to assess physical activity in cohorts from around the world."

They added: "These findings will also be useful for any study investigating physical activity and other long-term health outcomes in existing cohort data."

Professor Nigel Arden from the University of Oxford, who led the study, said: "This is an important first step to allow us to combine data on physical activity and osteoarthritis from around the world. It will eventually allow us to produce evidence-based recommendations for exercise to optimise joint health."

Our view

Dr Devi Rani Sagar, interim research liaison and communications manager at Arthritis Research UK, said: "Exercise is very important for the millions of people living with the pain of osteoarthritis. We advise people to strike the right balance between rest and exercise; too much activity may increase pain, but too little can make joints stiffen up.

"Assessing the relationship between physical activity and osteoarthritis is important when trying to understand the condition. This relationship can be hard to understand at the moment, due to the differences in methods used in studies; this study is important, as it will allow researchers to be able to compare data from around the world to answer complex questions such as this.

"We hope that this will lead to greater insight into the condition and, ultimately, find new ways to help people with osteoarthritis manage their condition."

Published on 16 May 2017

Former rugby union players 'at greater risk of arthritis' (published on 12 October 2017)

Former rugby union players may be at a greater risk of developing arthritis and other musculoskeletal problems than the general population.

This is according to a new study led by the Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis at the University of Oxford, which has suggested that rugby players may need to be monitored specifically to help address the potential impact that playing the sport can have on their bodies.

The impact of rugby on bone health

Generally, exercise and physical activity are encouraged as a means of improving musculoskeletal health, but the high-impact nature of rugby union means that the sport is associated with a higher rate of injury than for non-contact sports.

As such, researchers examined morbidity and health-related quality of life trends among 259 former elite-level rugby players compared to the general population, finding that the occurrence of osteoarthritis, joint replacement and osteoporosis were all much higher in ex-rugby players.

Results published in the journal Scientific Reports also showed that more former players experienced a quality-of-life impact as a result of mobility and pain or discomfort issues affecting their ability to take part in usual activities and self-care, underlining the practical impact of these disease trends.

The need for specific monitoring among rugby players

Although it was also observed that rugby players were less likely to develop diabetes, the research nevertheless indicates that the sport can take a toll on the body that may require more targeted monitoring and research.

The researchers concluded: "The magnitude of musculoskeletal morbidity in this population warrants proactive education and management within this at-risk sporting population.

"Further research in other sports may encourage the adoption of a more proactive approach to long-term health within elite and recreational sports, encouraging healthy sporting activity for all participants."

Our view

Dr Natalie Carter, head of research liaison and evaluation at Versus Arthritis, comments: "Over 8.5 million people live with osteoarthritis in the UK. The condition is very painful and affects a person's everyday life. Our charity, Versus Arthritis, feels that it is very important for us to support studies like this.

"This study provides information for those who play the sport on the short and long-term risks and benefits associated with rugby. It is also hoped that further studies, building on this work, will generate better preventative advice and treatment for both professional and recreational sports players."

Published on 12 October 2017

Workplace adjustments 'can help rheumatoid arthritis patients return to work' (published on 14 December 2016)

Workplaces could be doing more to adjust their practices and provide greater flexibility in order to help rheumatoid arthritis patients return to work.

This is according to a new study from Lancaster University and the Arthritis Research UK-MRC Centre for Musculoskeletal Health and Work, which aimed to offer a different viewpoint on sickness presenteeism, or the practice of continuing to work despite illness.

A strong desire to work despite rheumatoid arthritis

Generally speaking, sickness presenteeism is seen as having negative consequences for businesses and individuals alike, yet equally there is a perception that returning to work can be a positive step for people with poor health.

For this study, in-depth interviews were conducted with 11 men and women with rheumatoid arthritis, with follow-ups conducted six months later. According to results published in the medical journal Disability and Rehabilitation, the disease often affected participants' ability to work, yet their motivation to continue working remained high.

Moreover, the implementation of workplace adjustments was shown to enable participants to stay in their jobs and restore their work capacity, which can be a positive move for their overall recovery.

Voluntary vs involuntary presenteeism

However, the report also underlined the importance of differentiating voluntary presenteeism - wherein people with ill health want to continue to work - with involuntary presenteeism, or the situation that arises when people feel pressured to work through an illness.

It was observed that managers' misinterpretation of organisational sickness absence policies can result in a lack of flexibility to accommodate the needs of workers with rheumatoid arthritis, which can lead to involuntary presenteeism or a delayed return to work.

The study concluded: "Workplace adjustments can facilitate voluntary sickness presenteeism. To reduce work disability and sickness absence, organisational policies should be sufficiently flexible to accommodate the needs of workers with fluctuating conditions."

Our view

Dr Natalie Carter, head of research liaison and evaluation at Versus Arthritis, commented: "Rheumatoid arthritis is a painful and continually fluctuating condition that affects more than 460,0000 people within the UK. The fluctuating nature of the condition not only makes workplace tasks like typing and writing difficult, but can also make planning ahead troublesome.

"As a charity, we know that people with arthritis want to work and that with reasonable adjustments many people can continue or return to work. We've recently just launched our Work Matters to Me campaign, which is calling on the government to support people with arthritis."

Versus Arthritis is calling for people with arthritis to sign our open letter asking the government to deliver better employment support for people with arthritis who want the opportunity to work, and to add their own working experiences to the consultation response.

Published on 14 December 2016