News February 2019 Issue

In The News: February 2019

Brisk Walking May Delay Need for Knee Replacement

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For people with knee osteoarthritis, does high-intensity walking help or hurt? A group of researchers who examined this question presented their findings at the Annual Meeting of the American College of Rheumatology (October 2018). With osteoarthritis, the cushioning cartilage that covers the ends of bones in joints wears down, which can cause pain and stiffness. Exercise, including walking, is recommended. Past research has been mixed on whether walking too briskly can cause further injury. The current study included over 1,800 people with knee osteoarthritis. They wore accelerometers (which measure step cadence to determine walking intensity) four or more days a week for five years. Participants who replaced five minutes per day of non-walking time with five minutes of moderate-to-vigorous intensity walking reduced their chances of having total knee replacement by 16 percent. Light intensity walking had no such effect.

Arthritis and Prediabetes Often Go Together

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About one-third of adults in the United States with prediabetes (high blood sugar levels that increase risk for full-blown type 2 diabetes) also have arthritis, according to a report by the Centers for Disease Control and Prevention (CDC) published in MMWR (November 2018). Physical inactivity and obesity increase risk for developing type 2 diabetes, and having arthritis can be a barrier to exercising. To examine the relationship between arthritis, prediabetes, physical inactivity and obesity, the CDC analyzed data from the 2009 to 2016 National Health and Nutrition Examination Surveys (NHANES), which included over 10,000 adults ages 20 and older. They found a high prevalence of arthritis among people with prediabetes. They also found that about half of adults with both arthritis and prediabetes did not engage in regular physical activity or were obese, further increasing risk for diabetes.

Soft Knee Brace Provides Stability for Knee Osteoarthritis

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People with achy, stiff knees from osteoarthritis can have instability, experienced as knee buckling or giving way. Knee braces, either soft or hard ones, often are recommended, and studies have shown that people who wear a soft knee brace report that it reduces knee instability. A study published in the journal Rheumatology (October 2018) examined whether self-reported improvements could be verified with an objective measure. The study included 38 people with knee osteoarthritis, who wore either a soft knee brace or no knee brace. The researchers had all participants walk on a treadmill. Level walking was followed by walking with mechanical disturbances, which mimicked slipping, tripping and sideways movement. This tested how well the participants responded to an unstable situation. The researchers found that wearing a soft brace significantly reduced knee instability by this objective measure.

Meditation Can Help Manage Chronic Pain

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Treating chronic pain from musculoskeletal disorders, such as back pain and arthritis, can be challenging. Pain medications, including nonsteroidal anti-inflammatory drugs and opioids, can have significant side effects. Nondrug approaches are needed. A study presented at the Annual Meeting of the American College of Rheumatology (October 2018) examined the effectiveness of a meditation program for 122 participants who engaged in mindful breathing techniques and meditation practices to cope with chronic pain and stress. They had weekly conference calls and monthly workshops with a meditation instructor and a social worker. The researchers found that 98 percent were highly satisfied with the program. One-third of participants reported using mindful breathing five or more times a week in place of medication.

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