Regarding how to talk patients to motivate them to action, Dr. Peeters notes, “Rheumatologists and other health professionals may reassure middle-aged women that being physically active is more likely to be beneficial for their joints than detrimental. Obese women may have concerns that an active lifestyle could damage their joints. The current findings take away these concerns. [Although] lower levels of physical activity appear to be sufficient to reduce the risk of developing joint pain and stiffness, 150 minutes of moderate- to vigorous-intensity activity per week is recommended for cardiovascular and metabolic benefits.”
“The key message is that at least low levels of physical activity should be maintained throughout mid-age for women to benefit from the protective effects on joint symptoms in later mid-age,” Dr. Peeters says. “Particularly in obese women, a physically active lifestyle contributes to reducing the risk of developing joint symptoms.”
Looking forward, Dr. Peeters indicates there is definitely room for more data gathering. “[Although] this study involved data from 6,661 women who were followed more than 12 years, an even larger sample would have allowed us to explore the different patterns of physical activity in greater detail. The analyses were based on crude measures of physical activity and joint symptoms based on self-report. Adding more specific and objective measures to the study would strengthen the evidence, and in combination with a larger sample size, would facilitate more detailed exploration of the influence of type and intensity of activities, and the type and severity of the joint symptoms. Biomarkers, such as inflammation markers and imaging, could provide further insight into the biological pathway explaining the association between physical activity and joint symptoms.”
Simple & Practical—Just What We Need
Rebecca Manno, MD, MHS, is an assistant professor of medicine in the Division of Rheumatology at Johns Hopkins University in Baltimore, and she admires the researchers’ work. “My first instinct is to congratulate the authors on tackling this important issue,” she says. “It is difficult to study physical activity, but they managed to have a very large sample size, as well as a long study period. Their research represents a solid contribution to the literature.”
“In essence, this study took a grounded approach to asking a simple and very practical question, ‘If someone is active, based on the degree of activity, what chances does he or she have of developing worsening joint symptoms?’” Dr. Manno says. “As doctors, we often find ourselves trying to explain to patients why it’s important not to sit on the couch or play video games for 18 hours per day, and these are new data we can lean on during those conversations. To date, it has been challenging to prove this association between joint longevity and activity, although we all believe it exists.”
