Norman Ng

Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial

IntroductionManagement of osteoarthritis (OA) includes the use of non-pharmacological and pharmacological therapies. Although walking is commonly recommended for reducing pain and increasing physical function in people with OA, glucosamine sulphate has also been used to alleviate pain and slow the progression of OA. This study evaluated the effects of a progressive walking program and glucosamine sulphate intake on OA symptoms and physical activity participation in people with mild to moderate hip or knee OA.MethodsThirty-six low active participants (aged 42 to 73 years) were provided with 1500 mg glucosamine sulphate per day for 6 weeks, after which they began a 12-week progressive walking program, while continuing to take glucosamine. They were randomized to walk 3 or 5 days per week and given a pedometer to monitor step counts. For both groups, step level of walking was gradually increased to 3000 steps/day during the first 6 weeks of walking, and to 6000 steps/day for the next 6 weeks. Primary outcomes included physical activity levels, physical function (self-paced step test), and the WOMAC Osteoarthritis Index for pain, stiffness and physical function. Assessments were conducted at baseline and at 6-, 12-, 18-, and 24-week follow-ups. The Mann Whitney Test was used to examine differences in outcome measures between groups at each assessment, and the Wilcoxon Signed Ranks Test was used to examine differences in outcome measures between assessments.ResultsDuring the first 6 weeks of the study (glucosamine supplementation only), physical activity levels, physical function, and total WOMAC scores improved (P < 0.05). Between the start of the walking program (Week 6) and the final follow-up (Week 24), further improvements were seen in these outcomes (P < 0.05) although most improvements were seen between Weeks 6 and 12. No significant differences were found between walking groups.ConclusionsIn people with hip or knee OA, walking a minimum of 3000 steps (~30 minutes), at least 3 days/week, in combination with glucosamine sulphate, may reduce OA symptoms. A more robust study with a larger sample is needed to support these preliminary findings.Trial RegistrationAustralian Clinical Trials Registry ACTRN012607000159459.

Estimating physical activity and sedentary behavior in a free-living context: a pragmatic comparison of consumer-based activity trackers and ActiGraph accelerometry

Background Activity trackers are increasingly popular with both consumers and researchers for monitoring activity and for promoting positive behavior change. However, there is a lack of research investigating the performance of these devices in free-living contexts, for which findings are likely to vary from studies conducted in well-controlled laboratory settings. Objective The aim was to compare Fitbit One and Jawbone UP estimates of steps, moderate-to-vigorous physical activity (MVPA), and sedentary behavior with data from the ActiGraph GT3X+ accelerometer in a free-living context. Methods Thirty-two participants were recruited using convenience sampling; 29 provided valid data for this study (female: 90%, 26/29; age: mean 39.6, SD 11.0 years). On two occasions for 7 days each, participants wore an ActiGraph GT3X+ accelerometer on their right hip and either a hip-worn Fitbit One (n=14) or wrist-worn Jawbone UP (n=15) activity tracker. Daily estimates of steps and very active minutes were derived from the Fitbit One (n=135 days) and steps, active time, and longest idle time from the Jawbone UP (n=154 days). Daily estimates of steps, MVPA, and longest sedentary bout were derived from the corresponding days of ActiGraph data. Correlation coefficients and Bland-Altman plots with examination of systematic bias were used to assess convergent validity and agreement between the devices and the ActiGraph. Cohen’s kappa was used to assess the agreement between each device and the ActiGraph for classification of active versus inactive (≥10,000 steps per day and ≥30 min/day of MVPA) comparable with public health guidelines. Results Correlations with ActiGraph estimates of steps and MVPA ranged between .72 and .90 for Fitbit One and .56 and .75 for Jawbone UP. Compared with ActiGraph estimates, both devices overestimated daily steps by 8% (Fitbit One) and 14% (Jawbone UP). However, mean differences were larger for daily MVPA (Fitbit One: underestimated by 46%; Jawbone UP: overestimated by 50%). There was systematic bias across all outcomes for both devices. Correlations with ActiGraph data for longest idle time (Jawbone UP) ranged from .08 to .19. Agreement for classifying days as active or inactive using the ≥10,000 steps/day criterion was substantial (Fitbit One: κ=.68; Jawbone UP: κ=.52) and slight-fair using the criterion of ≥30 min/day of MVPA (Fitbit One: κ=.40; Jawbone UP: κ=.14). Conclusions There was moderate-strong agreement between the ActiGraph and both Fitbit One and Jawbone UP for the estimation of daily steps. However, due to modest accuracy and systematic bias, they are better suited for consumer-based self-monitoring (eg, for the public consumer or in behavior change interventions) rather than to evaluate research outcomes. The outcomes that relate to health-enhancing MVPA (eg, “very active minutes” for Fitbit One or “active time” for Jawbone UP) and sedentary behavior (“idle time” for Jawbone UP) should be used with caution by consumers and researchers alike.

Correlates Of Physical Activity In Men And Women With Osteoarthritis: Findings From Australia: 2715

Osteoarthritis (OA) is the leading cause of pain and disability in Australia, and physical activity is a preferred treatment for OA symptoms. However, most people with OA are not engaging in health-enhancing activities recommended to relieve symptoms. Understanding the modifiable factors associated with these activities is necessary to encourage participation. PURPOSE: To examine the correlates of leisure-time physical activity (LTPA), strength training, and stretching exercises among individuals with OA. METHODS: As part of a mail survey, 485 individuals, aged 68.0 (SD=10.6) years, with hip or knee OA were asked about current use of 17 therapies for OA relief as well as about demographic, health-related and psychological factors. Associations with each activity outcome were examined in a multivariable logistic regression model, separately for men and women. RESULTS: Having the use of a walking aid was associated with LTPA in men and women (p<0.05). In men, attempting to lose weight and using massage therapy were associated with participation in both strength training and stretching exercises (p<0.05). In women, attempting to lose weight and taking an OA self-management program were associated with participation in strength training (p<0.05), and taking an OA self-management program, using orthotics in shoes, and the perceived benefits of physical activities were associated with stretching exercises (p<0.05). CONCLUSION: This is the first study to show that use of certain OA therapies is associated with participation in physical activities. Acknowledging the limitations of the cross-sectional design, the findings indicate important channels, such as OA self-management programs for women and massage therapists for men, for promoting activity. They also indicate the perceived need for aids, like walking aids and orthotics, for participation in health-enhancing activities.