Links between osteoarthritis and diabetes: implications for management from a physical activity perspective.

Osteoarthritis (OA) and type 2 diabetes mellitus (T2DM) often coexist in older adults. Those with T2DM are more susceptible to developing arthritis, which has been traditionally attributed to common risk factors, namely, age and obesity. Alterations in lipid metabolism and hyperglycemia might directly impact cartilage health and subchondral bone, contributing to the development/progression of OA. Adequate management of older persons with both conditions benefits from a comprehensive understanding of the associated risk factors. We discuss common risk factors and emerging links between OA and T2DM, emphasizing the importance of physical activity and the implications of safe and effective physical activity.

Comparing physical activity programs for managing osteoarthritis in overweight or obese patients.

Obesity is a well-known modifiable risk factor for osteoarthritis (OA) in weight-bearing joints, and is present in approximately 35% of individuals with OA. Obesity adds significant burden to individuals with OA and is associated with poorer functional status and greater disability. In addition to tackling OA-related impairments, such as pain and functional limitations, interventions in this population need to address bodyweight reduction, as well as promotion of active lifestyle behaviors. While exercise and regular physical activity participation are both recommended and beneficial for OA and obese populations, our current understanding of optimal strategies to improve function and health status in those who have both OA and obesity is limited. This review will summarize the current available evidence related to effectiveness of various physical activity interventions to reduce pain, improve function and overall health-related quality of life in overweight or obese individuals with OA.

The pain-relieving qualities of exercise in knee osteoarthritis.

The purpose of this review article is to explore the role of therapeutic exercise in managing the pain associated with knee osteoarthritis (OA). Therapeutic exercise is often recommended as a first-line conservative treatment for knee OA, and current evidence supports exercise as an effective pain-relieving intervention. We explore the current state of evidence for exercise as a pain-relieving intervention for knee OA. Next, the mechanisms by which knee OA pain occurs and the potential ways in which exercise may act on those mechanisms are discussed. Clinical applicability and future research directions are suggested. Although evidence demonstrates that exercise reduces knee OA pain, optimal exercise mode and dosage have not been determined. In addition, it is not clearly understood whether exercise provides pain relief via peripheral or central mechanisms or a combination of both. Published clinical trials have explored a variety of interventions, but these interventions have not been specifically designed to target pain pathways. Current evidence strongly supports exercise as a pain-relieving option for those with knee OA. Future research needs to illuminate the mechanisms by which exercise reduces the pain associated with knee OA and the development of therapeutic exercise interventions to specifically target these mechanisms.