‘Statistically significant but small’: Exercise may improve fatigue in osteoarthritis
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Evidence showing the positive impact of physical activity on fatigue in symptomatic osteoarthritis is encouraging but limited, according to a speaker at the 2022 OARSI World Congress.
“Fatigue is a common nonspecific symptom experienced by nearly half of all patients with osteoarthritis," Céline Labie, MSc, of the Musculoskeletal Rehabilitation Research Group in the department of rehabilitation sciences at KU Leuven in Belgium, said in her presentation.
She suggested that a growing body of evidence has shown fatigue to be a significant barrier to physical activity in this patient population.
“Interestingly, poor physical functioning and inactivity have also been found to be associated with higher fatigue levels in people with symptomatic osteoarthritis,” Labie said.
Despite a large number of studies evaluating both pharmaceutical and non-pharmaceutical interventions targeting fatigue in OA, the benefits of physical activity in these patients remains uncertain, she added.
The current study was a meta-analysis of randomized controlled trials in OA populations to determine the impact of physical activity on fatigue. In the initial search, the researchers found more than 4,000 records from seven databases.
Ultimately, five trials met inclusion criteria.
Three of the studies included 349 patients comparing exercise with no-exercise control groups. Interventions ranged from full-body yoga to hand exercises for patients with hand OA. The duration of the interventions was from 8 weeks to 3 months.
The mean age in this patient population was 65 years and the cohort was 75.4% women. Two of the studies included patients with hip or knee OA, while patients in the other study had hand OA.
“From the random effects meta-analysis, the pooled effect size was statistically significant but small in favor of exercise and physical activity interventions to decrease fatigue in short-term follow-up,” Labie said.
Two of the three studies had no risk for bias, while one had a high risk for bias, according to Labie.
“The overall quality of evidence for this outcome was classed as moderate,” she said.
The other two studies reported in the presentation involved 67 patients who were not included in the meta-analysis because they performed aquatic exercise interventions. However, the data demonstrated no statistically significant difference in fatigue after intervention, according to Labie.
“Both studies were classified as having a high risk for bias,” she said.
Labie concluded that exercise and physical activity interventions can be beneficial in improving perceived fatigue among OA patients. However, this conclusion should be considered with caution.
“The current small effect sizes, low number of studies reported and selection bias on intensity of fatigue limits the generalizability of the current evidence,” she said.
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Labie C. Effectiveness of exercise and physical activity interventions on fatigue in people with osteoarthritis: A systematic review with meta-analysis. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting).
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