Arthritis, Activity, and Remaining Active as You Age

Stacey Schepens Niemiec, PhD OTR/L2/7/2014

Arthritis in the US

Source: CDC, 2009

Future of Arthritis

Source: CDC 2009

Arthritis by Gender

Source: CDC 2009

Arthritis and Limitations

Source: CDC 2009

Arthritis

• Not a single disease• Different ages of onset• Different risk factors

© Adapted from MedicineNet, Inc.

OA versus RA

• Autoimmune• Any joint, symmetrical• Any age• May advance, full-

blown, over weeks or months

• Prevalent in women

• Degenerative• Overused joints• Older adults and those

involved in physical work or sports

• Develops over time• Prevalent in women

Osteoarthritis Rheumatoid Arthritis

OA and Symptoms

Pain

Stiffness

Fatigue

OA and Fatigue

Fatigue↓ Mobility

↓ Physical Activity

↓ Quality of Life

OA and Fatigability

ACTIVITY

FATIGUEFATIGABILITY

Fatigue experience Activity deficits

Research Gaps in Fatigability

• Understanding OA symptoms within the context of daily activity

• Understanding how symptoms and activity change after participation in physical and mental activities

Fatigability Studies

• In a study with older adults who engaged in physically fatiguing tasks, we found…

Schepens, Kratz, & Murphy, 2012

• Fatigue and activity levels and patterns were negatively affected on the task day

• Fatigue was lower for 3 days after the task day

• Pain remained consistent in levels and patterns

Fatigability Studies

• In a study with older adults who engaged in mentally fatiguing tasks, we found…

Kratz, Schepens, & Murphy, 2013

• Pain was lower and fatigue was higher on the task day and the next day

• Pattern of fatigue and activity changed and persisted for 4 days

• No changes in activity levels

Picture : http://www.otsegocountycoa.org/techage.cfm

What Exacerbates OA Symptoms?

• Paucity of causal research• Some theories:

Activity? Footwear? Weather?

Schepens, Kratz, Murphy, 2012; Kratz, Schepens, Murphy, 2013; Cited in: Hunter, Mcdougall, Keefe, 2008

Non-pharmacological OA Management

Lorig, Gonzalez, & Laurent, 2006; Murphy, Lyden, Smith, Dong, & Koliba, 2010

Knowledge Staying active, staying safe

Self-monitoring

Activity pacing Relaxation Openness

Acknowledgements• Dr. Schepens Niemiec is currently supported by (K12

HD055929) NIH – NCMRR and NINDS

• Fatigability studies were conducted at the Univ. of Michigan during Dr. Schepens Niemiec’s postdoctoral fellowship supported by NCMRR, NICHD, and NIH (5-T32-HD007422-17), and under the guidance of her mentor Susan Murphy, ScD OTR/L