Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Review

Volume 9, Number 5, May 2017, pages 375-381


Impact of Physical Activity in Cardiovascular and Musculoskeletal Health: Can Motion Be Medicine?

Tables

Table 1. Physical Activity and Cardiovascular Health [9-17]
 
Author/yearSubjectsNStudy typeFollow-upActivity descriptionOutcomes
*Metabolic equivalents of task.
Inoue et al, 2008 [9]Japanese citizens
45 - 74 years of age
83,034CohortMean 8.7 yearsDaily time spent on three types of physical activity: heavy physical activity, sedentary activity, and walking and standingPhysical activity significantly reduced the risk of cardiovascular disease (hazard ratio: lowest METS* = 1, second METS = 0.77, third METS = 0.62, highest METS = 0.63; P < 0.001)
Patel et al, 2010 [10]USA
50 - 74 years of age
123,216CohortMax. 14 yearsDaily time spent sitting and time spent on physical activityTime spent sitting was associated with a higher risk of cardiovascular disease mortality. There was a statistically significant inverse relationship between physical activity and cardiovascular disease mortality (P < 0.001)
Matthews et al, 2012 [13]USA
50 - 71 years of age>
240,814Cohort8.5 yearsDaily time spent on: television viewing, overall sitting, and moderate-vigorous physical activity (MVPA)Those reporting ≥ 7 h of TV viewing had almost twice the risk of cardiovascular mortality (HR: 1.85; 95% CI: 1.56 - 2.20), as compared to those reporting < 1 h of TV viewing after adjustment for MVPA. After adjustment for BMI, those reporting ≥ 7 h of TV viewing were at higher risk of cardiovascular mortality (HT: 1.62; 95% CI: 1.37 - 1.93)
Kim et al, 2013 [11]USA
45 - 75 years of age
134,596Cohort13.7 yearsDaily time spent sitting watching TV, sitting in other leisure activities; in a car/bus; at work; and at meals)The longer time spent sitting watching TV (510 h/day vs. < 5 h/day) is associated with an increased risk of cardiovascular mortality (men: HR: 1.19; 95% CI: 1.10 - 1.129; women; HR: 1.32; 95% CI: 1.21 - 1.44)
Katzmarzyk, 2014 [14]Canada
18 - 90 years of age
16,586Cohort12 yearsDaily time spent standing: none of the time, one-fourth of the time, half of the time, three-fourth of the time, almost all of the time.There was a statistically significant inverse relationship between successive levels of daily standing and cardiovascular mortality (HR: 1.0, 0.82, 0.84, 0.68, 0.75; P = 0.02 for standing none of the time, one-fourth of the time, half of the time, three-fourth of the time, almost all of the time).
Matthews et al, 2014 [12]USA
40 - 79 years of age
63,308Cohort6.4 yearsDaily time spent performing light, moderate, and strenuous physical activity. In addition exercise and sports participation was assessed. Time spent sitting in a car or a bus, work, viewing TV, using a computer, and other activities. Physical activity was converted to estimates of METS.Black adults who had the highest level of physical activity had lower risk of death from cardiovascular disease (HR: 0.81; 95% CI: 0.67 - 0.98). White adults (HR: 0.69; 95% CI: 0.49 - 0.99).
Bjork Petersen et al, 2014 [15]Denmark
18 - 99 years of age
71,363Cohort5.4 yearsDaily time spent sitting was assessed. In addition, various levels of physical activity were evaluated (vigorous, moderate, light, and inactive).Those who spent more than 10 h/day compared to less than 6 h/day sitting had higher risk of developing MI (HR: 1.38; 95% CI: 1.01 - 1.88) but not CHD (HR: 1.07; 95% CI: 0.91 - 1.27).
Those who spent less than 6 h/day sitting and being physically active compared to those who spent more than 10 h/day sitting and being physically inactive had lower risk of developing MI (HR: 1.8; 95% CI: 1.15 - 2.82) and coronary heart disease (HR: 1.42; 95% CI: 1.11 - 1.81).
Dunstan et al, 2010 [16]Australia
≥ 25 years
8,800Cohort6.6 years (median)Daily time spent viewing television was assessed. Adjustments for age, sex, waist circumference, and exercise were made.The hazard ratio for each additional 1 h of TV time per day was 1.18 (95% CI: 1.03 - 1.35) for cardiovascular mortality. When comparing TV time of < 2 h per day the hazard ratios for cardiovascular mortality were 1.19 (95% CI: 0.72 - 1.99) for ≥ 2 h per day and 1.80 (95% CI: 1.00 - 3.25) for ≥ 4 h per day.
Wijndaele et al, 2011 [17]UK13,197Cohort9.5 yearsDaily time spent viewing television was assessed. Adjustments for gender, age, education, smoking, alcohol, medication, diabetes history, family history of cardiovascular disease and cancer, BMI, and physical activity energy expenditure (PAEE)An increase of 1 h per day of TV time was associated with a hazard ratio of 1.07 (95% CI: 1.01 - 1.15) for cardiovascular mortality.

 

Table 2. Physical Activity and Osteoarthritis [18-27]
 
Author/yearSubjectsNStudy typeFollow-upInterventionOutcomes
Lo et al, 2016 [20]Osteoarthritis initiative (OAI) participants2,637, 55.8%, femaleRetrospective cross-sectional8 yearsKnee X-ray readings, symptom assessments and lifetime physical activity surveys. Compared those who ran and those who did not run.Odds ratio: pain 0.83 and 0.71 (P = 0.002), radiographic OA 0.83 and 0.78 (P = 0.01), symptomatic OA 0.81 and 0.64 (P = 0.0006). There is no increased risk of OA in self-selected runners.
Kwee et al, 2016 [27]OAI participants with dAB at the cMF at baseline51 M, 49 FCohort2 yearsEffect of physical activity on progression of knee OA using 2-year follow-up MRI.No association between physical activity and 2-year MTFC cartilage change.
Foroughi et al, 2011 [25]Women > 40 with primary OA in at least one knee54 FRCT6 monthsSix months of high-intensity progressive resistance vs. low-resistance exercise (sham regimen).There was no difference in the first peak knee or hip adduction moment (P > 0.413). The second peak adduction moment was reduced significantly (P = 0.025), as well as WOMAC pain score (P < 0.001) in both groups.
Jan et al, 2008 [22]> 50 years old with confirmed OA79 F, 19 MRCT8 weeksEight weeks of high-resistance (HR) or low-resistance (LR) exercise or no exercise (control).There was statistically significant reduction in pain and improvement in function in patients who were in high-resistance and low-resistance cohorts. There was no significant difference between the high and low resistance cohorts.
Mangione et al, 1999 [23]Community dwelling ≥ 50 years old with painful OA26 F, 13 MRCT10 weeksHigh effort (70% of heart reserve) or low effort (40% of heart reserve) for 10 weeks of stationary cycling.There was a significant improvement in chair rise time, (P < 0.001), 6-min walk (P < 0.001), AIMS2 pain score (P < 0.001), and Aerobic capacity GXT time (P < 0.001) from pre-intervention to post-intervention in both cohorts.
McCarthy et al, 2004 [26]> 50 years old meeting the ACR’s classification of OA125 F, 89 MRCT1 yearHome exercises only or home exercises with addition of 8 weeks of twice-weekly knee classes run by a physiotherapist.There was significant improvement for the class-based group in locomotor function (-2.9 s; 95% CI: -4.0 to -1.8) and walking pain (-14.9 mm; 95% CI: -18.1 to -11.7) compared to home-based group.
Ng et al, 2010 [24]40 - 75 years old with hip or knee OA17 F, 11 MRCT24 weeksHigh-intensity (walk 5 days/week) or low-intensity (walk 3 days/week). Up to 3,000 steps/day for first 6 weeks, up to 6,000 steps/day for the next 6 weeks. Final 6 weeks, exercise program of patient’s choice. Eighteen weeks of glucosamine (GS) intake (1,500 mg/day) started 6 weeks before walking regimens. Patients could choose to stop GS in the final 6 weeks (weeks 18 - 24).GS only period led to improvements in activity levels, physical function and WOMAC scores (P < 0.05). Further improvement seen in these outcomes after walking regimen started (P < 0.05). No difference between high intensity and low intensity groups.
McAlindon et al, 1999 [21]Framingham heart study patients with radiographic normal knees at baseline470Cohort8 years (Biennial exam 18 - exam 22)Patients with normal knees on radiograph at exam 18 received follow-up radiographs on exam 22 to assess for radiographic OA or symptomatic OA.Heavy physical activity increases incidence of radiographic OA (OR = 1.3/h; P = 0.006). The risk was even greater for obese individuals (OR = 13.0). Similar results for symptomatic OA, but not significant due to small number of cases.
Felson et al, 2007 [19]Framingham heart study1,279Cohort9 yearsPatients without OA at baseline were surveyed on pain and physical activity, and had knee radiographs performed. Nine years later, they were assessed for radiographic OA, symptomatic OA, and joint space loss.In middle-aged and elderly without knee OA, recreational exercise did not protect against or increase the risk of OA regardless of BMI.
Plotnikoff et al, 2015 [18]Non-institutionalized individuals ≥ 18 years1,808Cross-sectionalNo follow-upPhase 1 consisted of a phone interview. Phase 2 included clinical measurements and additional self-reported health information.In a logistic regression model, physical activity was not associated with OA prevalence.
Being obese was strongly associated with knee and hip OA prevalence (OR: 4.37 and 2.52).