1. 1 OA Action Alliance Physical Activity Workgroup July 7, 2011

2. 2 Background 49.9 million American adults (22.2 percent of the U.S. population) have arthritis More than 42 percent of them, or 21.1 million adults, have activity limitations attributable to their arthritis. Nearly half (47 percent) of adults with arthritis have at least one other chronic condition, the most common of which is heart disease, chronic respiratory conditions, diabetes, or stroke

3. 3 Adults with arthritis have higher rates of inactivity than those without the disease 45 percent of adults with arthritis are considered inactive (defined as 0-9 minutes of aerobic physical activity per week) as compared to 36 percent of adults with no arthritis.

4. 4 Recommendations for the management of arthritis—from clinical treatment guidelines to A National Public Health Agenda for Osteoarthritis—have included physical activity among the interventions proven effective for improving the lives of adults with arthritis

5. 5 Recommended Physical Activity for Adults (Including Adults with Arthritis) Adults need at least 2 hours and 30 minutes a week of moderate-intensity, or 1 hour and 15 minutes (75 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. Aerobic activity should be performed in episodes of at least 10 minutes, preferably spread throughout the week. In addition, adults need muscle-strengthening activities that involve all major muscle groups performed on 2 or more days per week. Additional health benefits are provided by increasing to 5 hours (300 minutes) a week of moderate-intensity aerobic physical activity, or 2 hours and 30 minutes a week of vigorous-intensity physical activity, or an equivalent combination of both.

6. 6 Special Considerations for Adults with Chronic Conditions (including Osteoarthritis) Adults with chronic conditions obtain important health benefits from regular physical activity. When adults with chronic conditions do activity according to their abilities, physical activity is safe. Adults with chronic conditions should be under the care of health care providers. Adults with chronic conditions and symptoms should consult their health care providers about the types and amounts of activity appropriate for them.

7. 7 OA Agenda A National Public Health Agenda for Osteoarthritis sets the stage for a collaborative and focused initiative to achieve three overall goals over the next three to five years: –Ensure the availability of evidence-based intervention strategies — such as self management education, physical activity, injury prevention, and weight management and healthy nutrition — to all Americans with OA –Establish supportive policies, communication initiatives and strategic alliances for OA prevention and management –Initiate needed research to better understand the burden of OA, its risk factors and effective strategies for intervention.

8. 8 OA Agenda: 10 recommendations Recommendation 2: Low impact, moderate intensity aerobic physical activity and muscle strengthening exercise should be promoted widely as a public health intervention for adults with OA of the hip and/ or knee. Increase access and continue to identify additional effective packaged programs for physical activity that can be delivered safely in a variety of accessible and acceptable formats and settings. Implement the 2008 US Department of Health and Human Services Physical Activity Guidelines for Americans fully and encourage expanded strategies to increase physical activity and reduce inactivity among people with OA. Build supportive environments by implementing built-environment, land use and design policies and other policy and environmental supports proven to increase physical activity, such as those found in the Guide to Community Preventive Services and other evidence-based sources.

9. 9 OA Agenda: Physical Activity Recommendations Design packaged programs Implement physical activity guidelines Build supportive environments Overcome barriers to activity and participations

10. 10 Policy and Strategy Recommendations The next slide highlights the short list of priority policies and environmental strategies that are most practical and doable, likely to have the greatest impact on adults with arthritis, able to be initiated within 1-2 years, and sustainable over time.

11. 11 Table 1. Priority Policies and Environmental Strategies for Improving Physical Activity Among Adults with Arthritis Park, Recreation, Fitness, and Sports Park, recreation, fitness, and sport professionals should receive training on how to adapt and modify physical activity programs and exercises for adults with arthritis and assist them in initiating and sustaining appropriate physical activity. Business and Industry Comprehensive worksite wellness programs should protect privacy while explicitly incorporating the needs of adults with arthritis in their programs and making arthritis information widely available. Community and Public Health Public health, aging services networks, faith-based organizations, and other community agencies should partner to identify, promote, and deliver evidence-based physical activity programs for adults with arthritis. Health CareLicensed health care professionals should ask arthritis patients about physical activity levels at every visit, screen for arthritis-specific barriers to physical activity, encourage physical activity, and recommend evidence-based community or other physical activity interventions when appropriate. Transportation, Land Use, and Community Design Laws and regulations should be passed and reinforced to create or expand efforts to promote active living environments that can support adults with arthritis being physically active. Mass MediaAvailable evidence-based physical activity interventions for adults with arthritis should be promoted through information, guidelines, signage, media promotion, and public outreach.

12. 12 OAAA inaugural meeting in DC Information clearinghouse Motivational Interviewing Making physical activity a vital sign Involve employers in priority physical activity for people with arthritis