What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis

Objective: To determine the proportion of people with hip and knee osteoarthritis that meet physical activity guidelines recommended for adults and older adults. Method: Systematic review with meta-analysis of studies measuring physical activity of participants with hip and knee osteoarthritis using an activity monitor. Physical activity levels were calculated using the mean average [95% confidence interval (CI)] weighted according to sample size. Meta-analyses determined the proportion of people meeting physical activity guidelines and recommendations of (1) ≥150min per week of moderate to vigorous physical activity (MVPA) in bouts of ≥10min; (2) ≥150min per week of MVPA in absence of bouts; (3) ≥10,000 steps per day and ≥7000 steps per day. The Grades of Research, Assessment, Development and Evaluation (GRADE) approach was used to determine the quality of the evidence. Results: For knee osteoarthritis, 21 studies involving 3266 participants averaged 50min per week (95% CI=46, 55) of MVPA when measured in bouts of ≥10min, 131min per week (95% CI=125, 137) of MVPA, and 7753 daily steps (95% CI=7582, 7924). Proportion meta-analyses provided high quality evidence that 13% (95% CI=7, 20) completed ≥150min per week of MVPA in bouts of ≥10min, low quality evidence that 41% (95% CI=23, 61) completed ≥150min per week of MVPA in absence of bouts, moderate quality evidence that 19% (95% CI=8, 33) completed ≥10,000 steps per day, and low quality evidence that 48% (95% CI=31, 65) completed ≥7000 steps per day.For hip osteoarthritis, 11 studies involving 325 participants averaged 160min per week (95% CI=114, 216) of MVPA when measured in bouts of ≥10min, 189min per week (95% CI=166, 212) of MVPA, and 8174 daily steps (95% CI=7670, 8678). Proportion meta-analyses provided low quality evidence that 58% (95% CI=18, 92) completed ≥150min per week of MVPA in absence of bouts, low quality evidence that 30% (95% CI=13, 50) completed ≥10,000 steps per day, and low quality evidence that 60% (95% CI=47, 73) completed ≥7000 steps per day. Conclusion: A small to moderate proportion of people with knee and hip osteoarthritis met physical activity guidelines and recommended daily steps. Future research should establish the effects of increasing physical activity in this population to meet the current physical activity guidelines.