Just ten minutes a day of brisk walking can reduce the likelihood of impaired mobility in older adults by 85%. Similarly, the risk of difficulties with daily tasks such as bathing and dressing, can be reduced by 45%. All this emerges from a study by Northwestern University’s Feinberg School of Medicine in Chicago.
Participants were adults aged 45 to 79, at elevated risk of osteoarthritis of the knee, based on factors such as age, BMI, previous injury etc. Four years after the start of the study, 24% of adults who did not get the weekly hour of brisk walking were moving too slowly to safely cross the street, and 23% reported problems performing morning routines like getting dressed.
Lead author of the study, Professor Dorothy Dunlop, said “This minimum threshold may motivate inactive older adults to begin their path toward a physically active lifestyle with the wide range of health benefits promoted by physical activity.”
(One Hour a Week: Moving to Prevent Disability in Adults With Lower Extremity Joint Symptoms. American Journal of Preventive Medicine, online 19 March 2019.)
A team researchers at the University of Coimbra, Portugal, studying acupuncture for rheumatoid arthritis of the hand, has concluded it is effective at reducing pain and disability. They randomly assigned 105 patients, mean age 57, to either true acupuncture, sham acupuncture or a waiting list control. True acupuncture was associated with significantly improved pain, pressure pain threshold, hand grip and arm strength. The number of swollen and/or tender joints also significantly decreased. Health status and quality of life significantly improved with acupuncture.
Sham acupuncture was associated with no significant changes, other than pain improvement. Those on the waiting list showed an overall worsening. The researchers state that the rigorous design of this randomised controlled trial avoids major problems of other studies such as nonspecific effects, weak allocation of acupoints, or lack of objective assessment of effects. They go on to point out the nonpharmacologic and nontoxic nature of acupuncture, which constituted an effective and well-tolerated treatment.
(Effectiveness of Acupuncture on Pain, Functional Disability, and Quality of Life in Rheumatoid Arthritis of the Hand: Results of a Double-Blind Randomized Clinical Trial. Journal of Alternative & Complementary Medicine, January 2019.)
A systematic review by authors at Stanford University’s Department of Medicine and the University of Bologna, has concluded that acupuncture and electrotherapy can reduce opioid consumption after total knee replacement (arthroplasty). A total of 39 randomised trials involving almost 2400 patients, were examined. The trials studied a variety of drug-free interventions including passive motion, preoperative exercise, cryotherapy, electrotherapy and acupuncture. Moderate-certainty evidence showed that acupuncture reduced and delayed opioid use, as did electrotherapy. There was also low-certainty evidence that acupuncture improved pain, based on patients’ visual analogue scores. None of the other therapies showed any significant effect on pain or opioid use.
(Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review & Meta-analysis. Journal of the American Medical Association Surgery, 18 October 2017.)
Authors in China have undertaken a systematic review of trials of electro-acupuncture for knee osteoarthritis. They examined 11 randomised controlled trials involving a total of nearly 700 participants. Meta-analysis suggested electro-acupuncture was more effective than medication, and standard acupuncture alone. It reduced pain intensity and improved physical function without any serious adverse events reported. The results implied electro-acupuncture should be given for at least four weeks, for 20-30 minutes per session.
(Electro-Acupuncture is Beneficial for Knee Osteoarthritis: The Evidence from Meta-Analysis of Randomized Controlled Trials. American Journal of Chinese Medicine, 2017.)
UK researchers assessing economic data on twelve non-pharmacological interventions for osteoarthritis of the knee, have found acupuncture and TENS (transcutaneous electrical nerve stimulation) to be cost-effective. The authors looked at 88 randomised controlled trials covering 7500 patients. They based cost-effectiveness estimations on a threshold of £20-30 000 per quality-adjusted life year; this is the same threshold used by NICE when establishing whether a treatment is a cost-effective use of NHS resources.
The authors noted that while acupuncture is not yet recommended by NICE as a treatment for knee osteoarthritis, their calculations suggest some interventions which are recommended (insoles, braces and manual therapy) are unlikely to be cost-effective.
(Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee. PLoS One, 7 March 2017.)