Arthritis and barriers to physical activity throughout the lifespan: A systematic review of the literature

Background: Musculoskeletal conditions cause a substantial public health burden on the US population. Arthritis affects 20 per cent of the population and an estimated 60 million Americans will be affected by arthritis by 2020. Arthritis is a potential cause of physical inactivity, which is associated with chronic diseases (obesity, cardiovascular diseases). The purpose of this study is to systematically review the literature on arthritis as a barrier to physical activity throughout the lifespan. Methods: A search of PubMed for all subject ages and all languages from 1960- January 2012 was performed using the terms: arthritis and (“physical activity" or exercise) and (barrier or limitation), in addition to the terms “arthritis-attributable activity limitation.” Papers were selected using inclusion criteria (arthritis as a barrier to exercise/activity) and exclusion criteria (treatment of conditions, commentaries, case reports, and correspondence), evaluated for quality and summarized. Results: The search resulted in 130 potential articles and 38 were selected as relevant. Physical activity appears to be limited in those with arthritis and more limited in those with comorbidities such as obesity, cardiovascular disease, and diabetes. There are multiple factors associated with arthritis and physical activity limitations, such as amount of pain, number of joints involved, proprioception, psychosocial factors, sex, race/ethnicity, and community/environment. Conclusion: There is a growing body of evidence that identifies arthritis as a barrier to physical activity throughout the lifespan. Arthritis may contribute to reduced physical activity and therefore may influence other chronic diseases associated with physical inactivity such as obesity and cardiovascular disease.