What are the factors that influence physical activity participation in adults with knee and hip osteoarthritis? A systematic review of physical activity correlates

OBJECTIVE: To determine the factors associated with physical activity participation in adults with hip or knee osteoarthritis.

METHODS: A systematic review was conducted including searches of AMED, PsycINFO, CINAHL, MEDLINE, EMBASE, PubMed and the Cochrane Library from inception until October 2013. Studies presenting quantitative correlates of physical activity in adults with hip and/or knee osteoarthritis were included. Two independent authors conducted the searches, extracted data and completed methodological quality assessment. Correlates were analysed using the summary code approach within the socio-ecological model.

RESULTS: A total of 170 correlates were identified from 29 publications analysing 8076 individual people with hip or knee osteoarthritis. Methodological quality was generally good. For knee osteoarthritis, factors consistently negatively associated with physical activity (reported more than four studies) were increasing age (number of participants in studies supporting association = 4558), non-white ethnicity (n = 3232), increased osteoarthritis symptoms (n = 2374) and female gender (n = 4816). Greater lower limb function (n = 1671) and faster gait speed were (n = 4098) positively associated with physical activity. Social (e.g. support from spouse (n = 141)) and environment (outdoor temperature (n = 38)) factors were identified as possible factors that influence physical activity. For hip osteoarthritis, higher body mass index (n = 99), increased comorbidities (n = 1021), lower mental health (n = 189) and unemployment (n = 65) were negatively associated with physical activity; while better social functioning (n = 1055) and health-related quality of life were positively associated with physical activity (n = 34).

CONCLUSION: Demographic, physical, social, psychological and environmental factors are all important correlates for physical activity for people with knee or hip osteoarthritis. Clinicians should consider these in clinical practice.