Research to Crack the ‘Balancing Act’ of Living Well with Knee Osteoarthritis

Chief Investigator

Dr Erin MacIntyr

University of South Australia

Award and Funder

Arthritis Australia National Research Program Grant-In-Aid (2025)

Funded by Arthritis Australia and Arthritis Western Australia

Plain Language Summary

Getting the right balance of activities (sleep, sedentary time, and physical activity) throughout a day is important for our overall health and wellbeing. This is especially true for people with knee osteoarthritis. It’s hard to know how much sleep, exercise, and rest to do during a day to improve your knee symptoms, as the best mix of activities is different for everyone. Adding to the difficulty is the fact that there are only 24 hours in a day, so doing more of one activity means missing out on something else. Activity trade-offs are complicated to get right and may have unintended consequences. For example, could waking up early to squeeze in more exercise at the expense of sleep inadvertently increase knee osteoarthritis pain? Or, if you already work at a physical demanding job, should you prioritise rest over more exercise when you are at home? Not knowing the answers to these questions means that it is hard for people with knee osteoarthritis to know what to do, and hard for clinicians to offer the best recommendations to their patients.

To answer these questions, we used a large dataset, which included over 12,000 people with knee osteoarthritis, to determine what balance of activities is best for each person with knee osteoarthritis, based on their unique profile (e.g., age, health status, current activity levels). We then built a web-app that allows people living with knee osteoarthritis and clinicians to view personalized recommendations for the best mix of activities to reduce knee pain. The app is interactive and allows user to explore the potential impact of small, realistic, changes in their daily activities, on knee osteoarthritis pain.

People with knee osteoarthritis often describe living with osteoarthritis as a ‘balancing act’ and tell us that is hard to know how much activity and rest is required to live well with knee osteoarthritis. We addressed this uncertainty, by creating the “Best Day for my Knee OA” web-app. This app gives people with knee osteoarthritis guidance about the best mix of activities to manage their knee osteoarthritis. It also provides information about the potential benefits of small activity changes on knee osteoarthritis symptoms. This allows people to make small, realistic lifestyle changes to better manage their knee osteoarthritis.
We found that one-size-fits-all recommendations, such as “move more, sit less”, may not work for everyone with knee osteoarthritis. Indeed, in some cases generic advice has the potential to worsen people’s symptoms. This tells us that lifestyle recommendations should be tailored to each individual based on their unique personal profile and current mix of daily activities. Personalisation has the potential to improve non-surgical management of knee osteoarthritis, by helping more people get their daily activity balance right.
This is the first time that impact of time-use swaps has been explored in people with knee osteoarthritis. Our findings provide evidence that personalised activity recommendations may be needed to improve outcomes in people with knee osteoarthritis. Next, we want to test using our new web-app in physiotherapy clinics. We want to know if the app itself is practical to use and is seen as a good thing to add to knee osteoarthritis treatment.
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