The benefits and barriers to physical activity and lifestyle interventions for osteoarthritis affecting the adult knee

Osteoarthritis (OA) is the most common form of arthritis, typically seen with increasing age affecting all joints. The majority of people over 60 years of age show evidence of osteoarthritis in at least one joint, with radiological evidence presenting in 70% of hips or knees of those older than 65 years [1]. The prevalence is 10% of 60 year olds and increases with age; the total number affected will have doubled by 2020. It is typified by morning pain, stiffness, swelling and deformity and risk factors include excessive force from repetitive impacts [2]. Body mass index is therefore also important. In addition, injury can also lead to abnormal strains upon individual joints [3]. Physical activity is limited by pain, eventually causing reduced muscle strength and atrophy. Features of Osteoarthritis section outlines typical features, which can be individually assessed and targeted for treatment.History: Pain, swelling, stiffness, heat, limp, reduced activity.Examination findings: Heat, pain, swelling, flexion deformity, weakness, restricted movement.Radiographic changes: Osteophytes, subchondral sclerosis, subchondral cysts, joint space narrowing, deformity, soft tissue calcification, effusion.Osteoarthritis has a significant socio-economic cost and therefore essential research is aimed at all levels of intervention and pathogenesis [4]. It is accepted that clinical function and radiological findings do not always parallel symptoms. For acute cases, management predominantly involves pain control, restoration of range of motion and swelling management. In the chronic state, a combination of pharmacological and non-pharmacological management exists. The latter includes muscle strengthening, range of movement therapy and aerobic conditioning in addition to occupational therapy, patella taping, weight loss, personalised social support, bracing, walking aids, and shock absorbent insoles [5].Recent reviews of exercise with regard to osteoporosis, cardiovascular disease, dia