I exercise to postpone death – Interviews with persons with hip and/or knee osteoarthritis who are attending an osteoarthritis school

Abstract

Background: Physical activity (PA) and exercise constitute the first line of treatment for osteoarthritis (OA) of the hip and/or knee. Even though the symptoms may vary, OA should be considered a chronic disease and therefore PA and exercise should be performed lifelong. That needs knowledge and motivation. Purpose: The purpose of this study was to explore and create a deeper understanding of the motivational processes for PA and exercise for persons with hip and/or knee OA who have participated in a self-management program OA school that included long-term exercise supervised by physical therapists. Methods: Twenty-two in-depth interviews were conducted with 18 participants recruited from the OA school at a Physical Therapy Rehabilitation Clinic in Sweden. The interviews were analyzed with qualitative content analysis. Results: The analysis resulted in one main theme, Developing health literacy to encourage motivational processes for PA and exercise in OA and four themes: 1) meeting an established selfmanagement program; 2) carrying my life history; 3) understanding the intelligence of the body; and 4) growing in existential motivation Conclusion: Motivation for being physically active and to exercise, the life history in relation to PA and what creates existential motivation are important areas to ask questions about when people come to OA schools. Knowledge about the signals of the body connected to OA should be implemented in OA schools in order to motivate people to live an active life despite OA. Health literacy and the awareness of how PA can postpone death are likely to be important for existential motivation.

Peoples' beliefs about their chronic hip pain and its care: a systematic review of qualitative studies. “I'm just getting old and breaking down”

“…13,59,82,83,96,104,114,120 However, medications and physiotherapy helped improve some peoples' pain, physical function, and mental health. 14,70,83,106,115,120,122…”

“…114,115,120 As people believed that they were not informed about pain with exercise, they were unsure whether pain with exercise was harmful or perceived it as harmful. 1,13,14,59,70,82,84,96,112,117 Some people were also dissatisfied with the experience of physiotherapy and general practice care: care was perceived as low value (eg, too much talking), 120 people perceived that advice…”

Osteoarthritis Literacy and Equity Issues: A Post COVID-19 Analysis and Update

“…In short, without a salient osteoarthritis disease understanding and knowledge about best choices in the self-care realm, unsafe behaviours, as well as uncontrollable eating behaviours, and a failure to appreciate the importance of sleep and stress reduction along with a failure to contain the pain associated with osteoarthritis and its disease progression disease are likely to heighten the need for high levels of dangerous narcotics as well as medications to counter reactive depression. As well, multiple additional self-management challenges may arise including fears of moving, as well as limitations in health seeking behaviours, poor adherence to recommendations, and an inability to function physically without undue fatigue, pain and immense distress [34].…”

“…As such, even if research is limited, an older adult with osteoarthritis may arguably suffer unduly because they are challenged in understanding what they need to do or why in order to remain in the community, rather than residing in a nursing home where their self-care role will be of less importance. As such, it appears reasonable to assert that if providers fail to appreciate COVID-19 implications, as well as the past social histories and ability to comprehend health messages of their older osteoarthritis clients, the capacity of the client for carrying out home based remedial approaches effectively and safely may be jeopardized [33,34,42] too challenged to decipher their health recommendations, or to contact their providers and seek advice, for example if they have limited feelings of confidence, or limited English language skills [36]. It appears therefore that a fair number of older adults with osteoarthritis may consequently fail to flourish even if they receive needed care if they fail to fully appreciate the importance of their lifestyle actions that are proven disease and disability predictors.…”

“…In this regard, a one size fits all approach may fail unless if the older adult is guided thoughtfully by the provider in light of their prevailing health status, as well as any mediating or possibly moderating epigenetic factors [37,38]. These understandings might include explanations about the specific importance of energy conservation and desirable sleep hygiene practices including physical activity participation in efforts to relieve pain, fatigue, and stiffness, and lessening reliance on medications, particularly during the early disease stages [34]. As well, heightened attention is currently indicated as far as creating personalized culturally relevant infection protection strategies, as well as nutritional and exercise approaches that respect affordability and access issues, along with their ability to act on these recommendations [37].…”