Background: It is well established that regular physical activity (PA) can prevent cardiovascular disease and retain optimal function in activities of daily living (ADL) in elderly people. However, PA decreases with age. The decreased PA does not only result from lifestyle factors especially found among older people. Health problems such as pain, limited flexibility, stiffness, and functional disability from osteoarthritis (OA) of the knee or chronic low back pain (CLBP) also represent important barriers to PA. Previous studies have demonstrated that low-intensity resistance exercise or acupuncture results in the improvement of health problems related to OA of the knee or CLBP.
Objective: To determine whether acupuncture combined with exercise would increase the level of PA assessed by the number of daily steps and improve functional performance in elderly people with OA of the knee or CLBP.
Participants: Three older people with OA of the knee (two women and a man, aged 69-72 years) and five older people with CLBP (three women and two men, aged 63-79 years) were included for analysis in the study.
Interventions: Subjects received acupuncture combined with weight-bearing resistance and a stretching exercise program for 8 weeks. Each subject was given acupuncture two times per week and implemented the exercise program five times per week (two supervised group sessions and three unsupervised home sessions). Subjects were not instructed to increase their daily level of PA.
Measurements: The outcome measures were the number of daily steps (measured by a pedometer, total number of daily steps, and the number of steps continued for over 10 min) as PA level, quadriceps femoris strength (isokinetic muscle strength at angular velocities of 60°/s), physical fitness test (distance of sit-and-reach, timed sit-ups, time of 10-m hurdle walking, and time of one leg standing with eyes open), level of pain, stiffness, and functional disability of knee (assessed by Western Ontario and McMaster Universities osteoarthritis index: WOMAC and radiography) and degree of dysfunction of CLBP (assessed by Roland-Morris disability questionnaire: RMQ and magnetic resonance imaging: MRI).
Results: A significant increase in total number of daily steps (from 3,990 ± 953 steps/day to 5,384 ± 1,420 steps/day, M ± SD, p = .004) and distance of sit-and-reach (from 30.9 ± 8.0 cm to 36.0 ± 8.8 cm, p = .006) was noted after the program. The number of steps continued for over 10 min had a tendency to increase after the program (from 325 ± 412 steps/day to 1,079 ± 960 steps/day, p = .051). There was no significant difference in quadriceps femoris strength, timed sit-ups, time of 10-m hurdle walking, time of one leg standing with eyes open, WOMAC score, or RMQ score after the program.
Conclusion: In older people with symptomatic knee OA and CLBP, acupuncture combined with exercise increases the number of daily steps. To establish these findings, further research with a larger number of subjects and comparison with controls is required.