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Hospital-Based Exercise Programs Benefit People with Osteoarthritis

Washington, D.C.—November 10, 2012

A low-cost exercise program run by Hospital for Special Surgery in New York City has significantly improved pain, function and quality of life in participants with osteoarthritis, according to new research.

The study adds to the growing evidence that exercise is beneficial for osteoarthritis and shows that a hospital-based program can work. The study will be reported at the annual meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP), to be held Nov. 9-14, in Washington D.C.

The new study showed that the weekly exercise programs significantly improved enjoyment of life and balance, and decreased pain and the severity and frequency of falls. “When participants were asked to report their level of pain severity, there were statistically significant reductions in pain from pre- to post-test. Pain is a huge factor in quality of life,” said Sandra Goldsmith, director of the Public and Patient Education Department at Hospital for Special Surgery. “If we can offer classes that help to reduce pain, that is a good thing.”

Roughly ten years ago, HSS launched its Osteoarthritis Wellness Initiative, which has grown to encompass both an educational component, including lectures and workshops, as well as exercise classes. In the study to be presented at the recent ACR/ARHP meeting, Special Surgery researchers evaluated the effectiveness of the exercise programs on 200 participants.

The classes, which met weekly throughout the year, included Tai Chi, yoga, mat and chair pilates, yoga-lates and dance fitness. Instructors who could tailor exercises for those with osteoarthritis and other musculoskeletal issues supervised the exercise programs. The researchers analyzed results from surveys that were administered before and after the exercise programs. The surveys included measures of self-reported pain, balance, falls and level of physical activity. An 11-point numeric pain intensity scale was used to quantify intensity of muscle or joint pain. The 10-point Brief Pain Inventory was used to measure pain interference on aspects of quality of life, including general activity, mood, walking ability, sleep, normal work (both outside the home and housework), and enjoyment of life.

In the sample of 200 participants, roughly 53% indicated that they experienced pain relief as a result of participating in the exercise programs. In fact, when researchers analyzed the subset of 66 participants who completed both pre and post surveys, a larger proportion, 62%, indicated they experienced pain relief after participating in the exercise programs. The level of pain intensity that participants experienced also significantly dropped from 4.5 to 2.7 in this group, where 0 was no pain and 10 was the worst pain imaginable. When researchers compared participants’ estimation of how much pain interfered with various aspects of an individual’s life, they identified a 54% improvement in general activity, mood, walking ability, sleep, normal work, and enjoyment of life.

“We asked participants to rate their balance, and we found a statistically significant increase in those who rated their balance as excellent, very good or good, from pre- to post-intervention, ” said Dana Friedman, MPH, outcomes manager in the HSS Public and Patient Education Department. Fewer respondents reported falling from pre- to post-test (14.5% vs. 13.1%), as well as sustaining injuries that required hospitalization (12.1% vs. 10.6%).

Linda Russell, M.D., a rheumatologist at HSS who is chair of the Public and Patient Education Advisory Committee, points out that the classes are low cost for patients and the fees cover the majority of costs associated with offering these types of programs, including salaries for the instructors. “We like to get all of our patients involved in exercise, and if we can help with a low-cost alternative to exercising in New York City, because gyms are expensive, then it is wonderful,” said Dr. Russell. “Patients benefit from supervised exercise programs with regard to their overall sense of well-being and pain due to their arthritis. We encourage other institutions to launch these types of program.”

“We’d like to be a role model for other hospitals, showing them that offering this type of program can help their patients reduce pain and improve quality of life,” said Ms. Goldsmith. “We are willing to discuss the details about how to start these programs.”

All exercise programs were run through the HSS Public and Patient Education Department, which includes the Greenberg Academy for Successful Aging, a collaborative program between the HSS Public and Patient Education Department and NewYork-Presbyterian Hospital’s Irving Sherwood Wright Center for the Aging.

Osteoarthritis is the leading cause of disability in the United States. According to the Centers for Disease Control and Prevention, an estimated 50 million U.S. adults, 22% of the population, suffered from osteoarthritis in 2009, compared with 46 million in 2003-2005. Arthritis affected the daily activities of 21 million adults in 2009. Body mass index influences the prevalence of arthritis; 29.6% of obese adults have arthritis.

Other Hospital for Special Surgery authors involved in the study include Linda Roberts, LCSW, Dana Sperber and Laura Robbins, DSW.

 

 

About HSS | Hospital for Special Surgery
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the ninth consecutive year) and No. 3 in rheumatology by U.S.News & World Report (2018-2019). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In 2017 HSS provided care to 135,000 patients and performed more than 32,000 surgical procedures. People from all 50 U.S. states and 80 countries travelled to receive care at HSS. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The culture of innovation is accelerating at HSS as 130 new idea submissions were made to the Global Innovation Institute in 2017 (almost 3x the submissions in 2015). The HSS Education Institute is the world’s leading provider of education on the topic on musculoskeletal health, with its online learning platform offering more than 600 courses to more than 21,000 medical professional members worldwide. Through HSS Global Ventures, the institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally.

 

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