Osteoarthritic Remedies Literature Review Chapter

experts would likely agree with the very general statement that individuals who exercise, or who implement an exercise regime, are much more likely to lose weight and alleviate pain experienced from a variety of diseases and maladies. It would seem that much of the current literature would provide evidence of this hypothesis. This specific study, however, seeks to do more than just ascertain the results from such a general question. This study seeks to determine whether initiating an exercise regime for patients experiencing osteoarthritis can lower the level of the pain they are feeling and increase their mobility through adherence to that regime.

This study will, in essence then, take a two-pronged approach. The first is to determine whether patients with suffering from osteoarthritis can lower the level and incidence of pain they suffer by implementing a basic exercise regime. If so, this study wishes to determine just how much lower and how fewer incidences will the patient experience on average. The second approach is based on the mobility of the patient and the question of whether the mobility increases with a certain amount of exercise. It is hypothesized that -- overall- the patients in the study will find relief of pain through exercise as well as an increased mobility.

A recent study determined that "quality of life is generally considered the state of physical, mental and social well-being" (Barile, Reeve, Smith, Zack, Mitchell, Kobau, Cella, Luncheon, Thompson, 2013, p. 1202). In other words, most people desire to be physically happy, mentally alert, and accepted in society. Or, as the Barile et al. study determined, more specifically; "health-related quality of life is measured by the aspects of overall quality of life that can be clearly shown to affect physical and mental health" (Barile et al., p. 1202).

Current literature contains a myriad of studies concerning quality of life as it concerns individuals experiencing osteoarthritis. Many of the studies include exercise, weight loss, and mobility issues. This study looks at two primary issues; exercise and mobility. One study determined that between the years 2002 and 2010 "there was no change in the proportion of adults with doctor-diagnosed arthritis who had ever taken a self-management education class (approximately 11%) or who had been counseled to engage in physical activity (approximately 52%)" (Do, Hootman, Helmick, Brady, 2011, p. 136). What is interesting about the Do et al. study is not that there was relatively little change in either approach, but that there was already 52% of the patients who had been counseled to engage in physical activity. Ironically enough, the study concerned arthritic patients who were obese or overweight, yet doctors who diagnosed the patients only recommended losing weight as an approach to alleviate pain and suffering 41% of the time. Compare the 41% of doctors who recommended losing weight to the 52% who recommended physical activity, and most people would likely say that it is more important to incorporate physical activity into the patient's lives than it is to incorporate losing weight. Of course, another way to look at this anomaly is to believe that losing weight is a natural result with a regular exercise regime, especially if the person who is doing the exercising is either overweight or obese. Other studies have stated similar sentiments; a 2007 study is a good example. The study found that arthritis development and progression is affected by obesity and that "weight loss can provide symptomatic benefit for adults with arthritis" (Fontaine, Haaz, Bartlett, 2007, p. 12).

That obesity and arthritis are ongoing issues in the health community is quite evident as even a 2003 study was bemoaning the fact that America had a weight issue.

The study determined that "obesity has reached epidemic proportions in the United States" (McInnis, Franklin, Rippe, 2003, p. 1249). This type of statement may be a little overboard, but it is true that there is a lot of people who need to eat less food and exercise more. The problem that arthritic individuals may be facing is that exercising (especially at the beginning of a regime) may cause them pain. It would seem likely that the thought of such pain puts a damper on their enthusiasm, therefore many likely procrastinate, and while they are procrastinating, they are putting on weight which leads to additional problems such as obesity.

According to the McInnis et al. study such problems makes vulnerable "more than 97 million Americans to a host of chronic diseases and conditions" (p.13). In fact, the same study shows that of those 97 million individuals "approximately 300,000 deaths each year are attributed to a combination of dietary factors and physical inactivity"(p. 13). According to the literature then, physical activity is a key factor to the health of Americans and therefore it should be a relatively simple task to get doctors and other medical professionals to incorporate physical activity data in the information that they give and the recommends that they make to patients. This will be an especially important part of this study due to the fact that a lot of studies have shown how obesity is one of the major factors affecting osteoarthritis.

One study puts it quite bluntly by stating "Excess weight is the major risk factor associated with various diseases, such as type 2 diabetes mellitus, hypertension, dyslipidemia and osteometabolic diseases, including osteoporosis and osteoarthritis" (Sartori-Cintra, Aikawa, Cintra, 2014).

Even more importantly perhaps is what else the study determined; the same study states "Osteoarthritis is the most prevalent rheumatic disease and the leading cause of physical disability and reduced quality of life of the population over 65 years" (Sartori-Cintra et al.). What this study seeks to determine is whether physical activity can benefit these individuals and assist them in achieving less pain, a higher quality of life and greater mobility. As the current literature demonstrates, such a laudable goal would help a lot of people in the United States, and around the world as well.

Current literature provides a variety of strong links between obesity and good (or bad) health. Additionally, since the links are so strong, it would also seem likely that those doctors or medical professionals that address this weighty issue would be doing their obese patients a favor. How much of a favor they would be doing is a question that will be answered, at least in part, by this study.

Based on the discussions contained above concerning obesity and health, it is generally assumed that losing weight (via exercise) is beneficial to most obese and overweight individuals. Additionally, a link has been established concerning the effects of obesity on osteoarthritis. As an example, a recent study determined "The frequency of knee osteoarthritis continues to accelerate, likely because of the increasing proliferation of obesity" (Sowers, Karovonen, 2010, p. 533). It would seem, therefore, that addressing the issue of obesity would likely be beneficial for osteoarthritic patients in the long-term. At least that is what the current literature leads researchers to believe. It has also been established that evidence-based practices assist medical professionals in the manner in which they diagnosis and treat patients.

There are numerous studies that confirm the evidence-based approach including a 2010 study that found that "evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values" (Stillwell, Fineout-Overholt, Melnyk, Williamson, 2010, p. 58). Additional studies have also shown that there are a number of groups that are affected in a negative manner and develop additional health problems if they do not exercise, if they do not watch their weight, and if they do not consistently take time in their lives to practice good health. One study found that "epidemiological patterns suggest that risk for overweight in the U.S. varies across social, economic, and racial/ethnic groups" (Cushing, Steele, 2014). The same study was able to discuss how "individuals with lower household incomes, those from rural communities and those who are African-American or Latino are at risk for obesity and overweight problems" (Cushing, Steele, 2014). All this data, and more presents opportunities for a study such as the one being proposed herein.

Establishing a link between good health, practices that lower the obesity rate, osteoarthritis, and mobility is something that has been addressed periodically and consistently throughout modern literature. It is the goal of this paper to determine whether recommending physical activity will assist patients suffering from osteoarthritis to alleviate pain, and/or increase mobility. Perusing current literature provides a basis for that hypothesis as evidenced by a number of studies such as the Edwards et al. study that determined that surgery weight loss has a very positive effect on knee pain in osteoarthritis of the knee.

The study determined that "isolated weight loss occurring via bariatric surgery resulted in statistically significant improvement in patient's knee arthritis symptoms in both six and twelve months" (Edwards, Rogers, Lynch, 2012). If what the Edwards et al. study found to be true is true,…