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Table 1.  

Activity group** No. of respondents % (95% CI)
Walking or backpacking 62,902 72.1 (71.4–72.7)
Walking 61,931 70.8 (70.2–71.4)
Hiking or backpacking 1,312 1.6 (1.5–1.8)
Lawn and garden 18,297 19.6 (19.1–20.2)
Gardening 12,094 13.3 (12.8–13.8)
Yard work 6,585 6.6 (6.3–7.0)
Muscle strengthening 9,885 12.8 (12.3–13.2)
Weightlifting 5,357 7.3 (7.0–7.7)
Calisthenics†† 2,014 2.6 (2.4–2.8)
Yoga 2,368 2.7 (2.5–2.9)
Pilates 349 0.4 (0.3–0.5)
Aerobic conditioning exercise 9,196 10.0 (9.6–10.4)
Bicycling machine exercise 4,241 4.5 (4.2–4.8)
Aerobics video or class 2,210 2.4 (2.2–2.6)
Elliptical or elliptical fitness crosstrainer machine exercise 1,675 2.1 (1.9–2.3)
Stair climbing or StairMaster 959 0.9 (0.8–1.1)
Other aerobic conditioning exercise 377 0.4 (0.4–0.5)
Home activities§§ 7,621 7.9 (7.5–8.2)
Sports 5,115 6.3 (6.0–6.7)
Golf 2,571 2.9 (2.7–3.1)
Bowling 394 0.5 (0.4–0.6)
Tennis 379 0.5 (0.4–0.6)
Other sports 1,881 2.6 (2.4–2.9)
Running or jogging 2,459 4.5 (4.2–4.9)
Water activities 3,654 4.4 (4.2–4.7)
Swimming 3,345 4.1 (3.8–4.4)
Other water activities 315 0.3 (0.3–0.4)
Bicycling 3,314 4.3 (4.0–4.6)
Dancing 966 1.3 (1.2–1.5)
Fishing and hunting 716 0.9 (0.8–1.0)
Farm or ranch work 1,182 0.9 (0.8–1.0)
Winter activities 900 0.6 (0.5–0.7)
Snow shoveling by hand 626 0.4 (0.4–0.5)
Other winter activities 286 0.2 (0.1–0.2)

Table 1. Weighted unadjusted percentages of adults with arthritis* who reported engaging in physical activity in the past month, reporting first or second most frequent activities§ — Behavioral Risk Factor Surveillance System, United States, 2019

Abbreviations: BRFSS = Behavioral Risk Factor Surveillance System; CI = confidence interval.

 

* Respondents were classified as having arthritis if they responded “Yes” to the question, “Have you ever been told you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?”

Respondents with arthritis were classified as engaging in physical activity if they responded “Yes” to the question, “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?”

§ Those who engaged in physical activity were classified as participating in an activity if they reported this activity in response to two questions: 1) “What type of physical activity or exercise did you spend the most time doing during the past month?” or 2) “What other type of physical activity gave you the next most exercise during the past month?” Participants who reported one activity but had missing data for the other most frequent activity (e.g., “don’t know” or “refused”) were included in the analysis. The sum of respondents for all activities exceeds the total number of respondents since each respondent could report up to two activities. Survey interviewers coded activities not listed among the 74 activities in the BRFSS Activity List for Common Leisure Activities into a single, heterogeneous “other” category representing a wide variety of different activities (n = 13,241; 13.7% [95% CI: 13.2–14.1]). https://www.cdc.gov/brfss/annual_data/2019/pdf/codebook19_llcp-v2-508.HTML

In 2019, New Jersey did not collect enough data to meet the minimum requirement for inclusion in the BRFSS public-use data set.

** The 74 activities were organized into major headings using a modified version of the 2011 Compendium of Physical Activities by Ainsworth, et. al. (https://cdn-links.lww.com/permalink/mss/a/mss_43_8_2011_06_13_ainsworth_202093_sdc1.pdf). Activities were grouped on the basis of similarity and on response rates, with activities having <400 respondents combined into “Other” categories corresponding to the major headings.

†† Some calisthenics activities might be classified as aerobic conditioning exercise.

§§ Home activities included household activities (e.g., vacuuming, dusting, or home repair), child care, carpentry, and painting or wallpapering.

Table 2.  

Characteristic No. of adults with arthritis engaging in physical activity Age-adjusted % (95% CI)*
Walking Gardening Weightlifting
Overall 87,299 70.0 (69.3–70.7) 10.7 (10.3–11.2) 10.3 (9.8–10.9)
Sociodemographic characteristic        
Age group, yrs (unadjusted)        
18–44 8,107 63.7 (61.8–65.5) 7.0 (6.1–8.0) 12.3 (11.1–13.6)
45–64 30,635 73.5 (72.6–74.5) 12.8 (12.0–13.7) 7.0 (6.5–7.6)
≥65 48,557 71.2 (70.3–72.0) 16.4 (15.7–17.1) 5.5 (5.1–6.0)
Sex
Male 34,886 63.9 (62.9–64.9) 10.9 (10.2–11.6) 10.9 (10.2−11.5)
Female 52,413 76.0 (75.2–76.7) 15.1 (14.5–15.8) 4.7 (4.3−5.1)
Race/Ethnicity
White, non-Hispanic 72,415 70.0 (69.4–70.7) 14.4 (13.9–14.9) 7.3 (6.9−7.7)
Black, non-Hispanic 5,607 75.4 (73.3–77.4) 7.8 (6.7–9.1) 7.9 (6.6−9.4)
Hispanic 3,059 72.8 (69.7–75.7) 11.7 (8.9–15.2) 7.3 (5.8−9.2)
Asian, non-Hispanic 794 72.1 (65.2–78.0) 11.4 (7.4–17.1) 8.7 (5.7−13.1)
American Indian or Alaska Native, non-Hispanic 1,290 74.8 (68.6–80.2) 8.0 (5.4–11.8) 4.4 (3.1−6.3)
Other/Multiple race, non-Hispanic 2,495 68.3 (64.5–71.9) 14.3 (11.7–17.3) 6.0 (4.6−7.9)
Highest level of education
Less than high school graduate 4,963 76.7 (74.5–78.7) 10.5 (9.1–12.0) 3.2 (2.4−4.3)
High school graduate or equivalent 21,782 71.7 (70.4–72.8) 13.6 (12.6–14.6) 5.5 (4.9−6.2)
Technical school or some college 26,276 70.8 (69.6–71.9) 14.5 (13.7–15.4) 6.7 (6.1−7.4)
College degree or higher 34,120 68.1 (67.1–69.1) 12.7 (12.0–13.5) 11.2 (10.5−11.9)
Employment status
Employed or self-employed 30,192 67.7 (66.6–68.8) 13.0 (12.1–13.9) 9.2 (8.6−9.9)
Unemployed 2,822 74.8 (71.2–78.1) 11.6 (9.5–14.1) 5.8 (4.2−8.1)
Retired 41,668 71.0 (69.8–72.2) 14.2 (13.3–15.1) 6.7 (6.0−7.6)
Unable to work or disabled 8,058 79.0 (77.1–80.7) 11.1 (9.9–12.5) 2.1 (1.7−2.7)
Student or homemaker 4,206 73.5 (70.8–76.0) 14.6 (12.7–16.7) 7.1 (5.6−9.1)
Federal poverty level††
≤125% FPL 11,478 77.3 (75.7–78.8) 11.0 (10.0–12.2) 3.4 (2.8−4.1)
>125% to ≤200% FPL 12,531 72.8 (71.2–74.3) 13.4 (12.2–14.7) 5.5 (4.6−6.4)
>200% to ≤400% FPL 21,874 70.7 (69.4–71.9) 14.7 (13.8–15.7) 7.2 (6.5−7.9)
>400% FPL 26,569 66.7 (65.5–67.8) 13.3 (12.4–14.2) 11.2 (10.4−12.0)
Sexual orientation§§
Straight 48,499 70.6 (69.7–71.4) 13.9 (13.3–14.6) 7.0 (6.5−7.5)
Lesbian, gay, bisexual, queer, or questioning 2,700 74.0 (70.9–76.9) 12.1 (9.9–14.8) 6.6 (4.9−8.8)
Urban-rural status¶¶
Large central metro 11,279 72.4 (70.8–73.9) 11.8 (10.6–13.2) 8.5 (7.6–9.4)
Large fringe metro 15,941 67.9 (66.6–69.2) 12.9 (12.1–13.8) 8.2 (7.4–9.1)
Medium metro 18,392 70.3 (69.1–71.4) 13.4 (12.6–14.3) 7.0 (6.4–7.6)
Small metro 12,587 70.2 (68.7–71.7) 13.9 (12.8–15.1) 6.8 (6.0–7.7)
Micropolitan 14,468 69.6 (68.2–71.1) 14.5 (13.5–15.6) 5.6 (4.9–6.5)
Noncore 14,632 71.9 (70.3–73.5) 15.7 (14.4–17.0) 4.0 (3.3–4.7)
Health-related characteristic
Joint pain severity***
None/Mild 46,371 69.1 (68.2–70.0) 13.5 (12.8–14.2) 9.4 (8.8−10.0)
Moderate 20,280 71.6 (70.3–72.8) 13.5 (12.6–14.4) 6.5 (5.8−7.3)
Severe 19,421 73.6 (72.4–74.9) 12.7 (11.8–13.7) 4.3 (3.7−4.9)
Body mass index (kg/m2)
Underweight or healthy weight (<25) 22,816 68.5 (67.2–69.7) 13.5 (12.6–14.5) 7.9 (7.2−8.7)
Overweight (25 to <30) 30,115 69.1 (68.0–70.1) 13.7 (12.8–14.6) 8.9 (8.3−9.7)
Obese (≥30) 30,171 73.6 (72.6–74.5) 12.9 (12.1–13.6) 5.9 (5.3−6.4)
Mobility limitations†††
No 63,303 69.7 (68.9–70.4) 13.9 (13.3–14.5) 8.6 (8.1−9.0)
Yes 23,530 73.9 (72.8–75.1) 11.8 (10.9–12.7) 3.9 (3.3−4.4)
Arthritis-attributable activity limitations§§§
No 54,910 70.1 (69.3–70.9) 13.3 (12.7–13.9) 8.6 (8.1−9.1)
Yes 31,562 71.9 (70.9–72.9) 13.4 (12.6–14.1) 5.3 (4.9−5.8)
Arthritis-attributable work limitations¶¶¶
No 63,083 70.1 (69.3–70.8) 13.0 (12.5–13.6) 8.7 (8.3−9.3)
Yes 22,660 72.4 (71.3–73.6) 14.0 (13.1–15.0) 4.5 (4.0−5.0)
Self-rated health
Excellent or very good 35,055 67.5 (66.4–68.4) 13.2 (12.5–14.0) 10.5 (9.8−11.2)
Good 31,206 72.1 (71.1–73.1) 14.5 (13.6–15.4) 6.2 (5.7−6.8)
Fair or poor 20,858 74.1 (72.9–75.3) 11.8 (11.0–12.7) 4.2 (3.6−4.8)

Table 2. Age-specific and age-adjusted* percentages of reporting walking, gardening, or weightlifting as a first or second most frequent activity among adults with arthritis§ who reported engaging in physical activity in the past month, by selected characteristics — Behavioral Risk Factor Surveillance System, United States,** 2019

Abbreviations: CI = confidence interval; FPL = federal poverty level.

* Except for age groups, age-adjusted estimates were generated in weighted logistic regression models that included age as a categorical covariate (18−44 years, 45−64 years, and ≥65 years).

Those who were engaging in physical activity were classified as participating in an activity if they reported this activity for one of two questions: 1) “What type of physical activity or exercise did you spend the most time doing during the past month?” or 2) “What other type of physical activity gave you the next most exercise during the past month?” Participants who reported one activity but had missing data for the second most frequent activity (e.g., “don’t know” or “refused”) were included in the analysis.

§ Respondents were classified as having arthritis if they responded “yes” to the question, “Have you ever been told by a doctor or other health care professional that you have arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?”

Respondents with arthritis were classified as engaging in physical activity if they responded “yes” to the question, “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?”

** In 2019, New Jersey did not collect enough data to meet the minimum requirement for inclusion in the BRFSS public-use data set.

†† FPL is the ratio of total family income to federal poverty level per family size. Overall, 14,847 adults with arthritis engaging in physical activity had missing FPL data.

§§ Sexual orientation was asked in 30 states (Alaska, Arizona, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Louisiana, Maryland, Minnesota, Mississippi, Montana, New York, North Carolina, Ohio, Oklahoma, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin). A total of 788 adults with arthritis who engaged in physical activity refused to answer.

¶¶ Urban-rural status was categorized using the National Center for Health Statistics 2013 Urban-Rural Classification Scheme for Counties. https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf

*** For the question, “On a scale of 0 to 10 where 0 is no pain or aching and 10 is pain or aching as bad as it can be, during the past 30 days, how bad was your joint pain on average,” an answer of 0−4 was defined as none/mild, an answer of 5−6 was defined as moderate, and an answer of 7−10 was defined as severe.

††† Respondents were classified as having mobility limitations if they responded “yes” to the question, “Do you have serious difficulty walking or climbing stairs?”

§§§ Respondents were classified as having arthritis-attributable activity limitations if they responded “yes” to the question, “Are you now limited in any way in any of your usual activities because of arthritis or joint symptoms?”

¶¶¶ Respondents were classified as having arthritis-attributable work limitations if they responded “yes” to the question, “In this next question, we are referring to work for pay. Do arthritis or joint symptoms now affect whether you work, the type of work you do, or the amount of work you do?”

Table 3.  

Jurisdiction Walking Gardening Weightlifting
Weighted no.** Unadjusted % (95% CI) Weighted no.** Unadjusted % (95% CI) Weighted no.** Unadjusted % (95% CI)
Alabama 548,000 75.4 (72.6−78.0) 111,000 15.3 (13.3−17.6) 39,000 5.3 (4.0−7.1)
Alaska 60,000 74.8 (69.7−79.3) 7,000 9.0 (6.2−12.9) 5,000 5.9 (4.0−8.8)
Arizona 603,000 73.3 (69.9−76.4) 82,000 9.9 (8.2−12.0) 73,000 8.9 (6.9−11.5)
Arkansas 278,000 71.6 (67.8−75.0) 62,000 16.0 (13.6−18.8) 19,000 5.0 (3.4−7.2)
California 3,053,000 74.2 (71.3−76.8) 653,000 15.9 (13.8−18.2) 330,000 8.0 (6.6−9.8)
Colorado 489,000 67.7 (65.1−70.3) 59,000 8.2 (6.8−9.8) 80,000 11.0 (9.4−12.9)
Connecticut 300,000 70.2 (67.3−72.9) 55,000 13.0 (11.2−15.0) 30,000 6.9 (5.5−8.7)
Delaware 86,000 70.4 (65.4−74.9) 16,000 13.0 (10.3−16.3) 7,000 5.3 (3.9−7.4)
District of Columbia 42,000 70.5 (64.8−75.6) 2,000 3.8 (2.3−6.2) 8,000 13.9 (9.7−19.7)
Florida 1,867,000 68.9 (65.7−72.0) 477,000 17.6 (14.5−21.2) 182,000 6.7 (5.2−8.7)
Georgia 793,000 70.2 (66.2−73.9) 137,000 12.2 (9.8−15.0) 96,000 8.5 (5.9−12.1)
Hawaii 100,000 62.9 (59.3−66.4) 24,000 15.3 (13.0−17.9) 12,000 7.3 (5.5−9.5)
Idaho 141,000 63.3 (58.4−67.9) 37,000 16.7 (13.7−20.2) 13,000 5.8 (3.8−8.7)
Illinois 1,067,000 67.6 (64.2−70.9) 209,000 13.2 (11.1−15.7) 130,000 8.3 (6.5−10.5)
Indiana 562,000 73.0 (70.2−75.6) 80,000 10.4 (8.7−12.3) 55,000 7.1 (5.6−8.9)
Iowa 276,000 68.9 (66.4−71.2) 46,000 11.5 (10.0−13.1) 27,000 6.8 (5.6−8.3)
Kansas 257,000 73.3 (70.9−75.5) 43,000 12.4 (10.9−14.1) 25,000 7.2 (5.8−8.8)
Kentucky 460,000 71.8 (68.4−75.0) 89,000 13.8 (11.7−16.3) 38,000 5.9 (4.3−8.2)
Louisiana 399,000 72.5 (68.6−76.1) 88,000 15.9 (13.3−19.0) 35,000 6.4 (4.4−9.3)
Maine 141,000 68.4 (65.5−71.1) 33,000 15.9 (13.9−18.0) 7,000 3.6 (2.5−5.2)
Maryland 522,000 71.5 (69.4−73.6) 81,000 11.1 (9.9−12.5) 62,000 8.6 (7.2−10.1)
Massachusetts 593,000 68.6 (65.3−71.7) 109,000 12.6 (10.5−15.0) 52,000 6.0 (4.6−7.7)
Michigan 1,132,000 73.4 (71.0−75.6) 152,000 9.8 (8.4−11.4) 111,000 7.2 (5.9−8.7)
Minnesota 469,000 71.1 (69.0−73.0) 103,000 15.6 (14.1−17.2) 40,000 6.1 (5.1−7.3)
Mississippi 243,000 73.7 (69.4−77.6) 43,000 12.9 (10.5−15.7) 18,000 5.6 (3.9−7.8)
Missouri 527,000 67.4 (64.0−70.6) 69,000 8.8 (7.1−10.9) 43,000 5.5 (4.3−7.1)
Montana 119,000 68.2 (65.4−71.0) 22,000 12.6 (10.8−14.8) 14,000 8.2 (6.6−10.1)
Nebraska 155,000 72.6 (70.3−74.8) 23,000 10.9 (9.5−12.5) 15,000 7.2 (5.8−8.8)
Nevada 251,000 68.8 (62.0−74.8) 27,000 7.5 (5.3−10.7) 36,000 9.8 (6.3−14.8)
New Hampshire 136,000 71.6 (68.2−74.7) 24,000 12.5 (10.5−14.8) 12,000 6.2 (4.5−8.3)
New Mexico 204,000 73.6 (70.2−76.7) 29,000 10.5 (8.6−12.8) 26,000 9.2 (7.3−11.6)
New York 1,509,000 73.5 (70.9−76.0) 202,000 9.8 (8.4−11.5) 148,000 7.2 (5.8−8.9)
North Carolina 970,000 69.0 (65.1−72.7) 242,000 17.2 (14.4−20.5) 97,000 6.9 (5.2−9.0)
North Dakota 64,000 65.1 (61.1−68.9) 10,000 10.2 (8.2−12.5) 9,000 9.6 (7.4−12.4)
Ohio 1,123,000 68.8 (66.3−71.3) 177,000 10.8 (9.6−12.3) 107,000 6.5 (5.2−8.2)
Oklahoma 325,000 71.1 (67.6−74.3) 42,000 9.1 (7.5−11.1) 35,000 7.6 (5.8−9.9)
Oregon 398,000 65.5 (62.1−68.8) 102,000 16.8 (14.3−19.8) 40,000 6.6 (4.9−8.8)
Pennsylvania 1,277,000 67.2 (64.0−70.3) 241,000 12.7 (10.7−14.9) 164,000 8.6 (6.8−10.9)
Rhode Island 101,000 71.2 (67.8−74.4) 19,000 13.3 (11.2−15.7) 10,000 7.0 (5.2−9.4)
South Carolina 504,000 75.4 (72.6−78.0) 99,000 14.8 (12.7−17.3) 48,000 7.2 (5.6−9.1)
South Dakota 68,000 65.3 (59.1−71.0) 8,000 8.1 (5.7−11.3) 9,000 8.8 (6.0−12.6)
Tennessee 662,000 74.3 (71.0−77.3) 117,000 13.1 (11.0−15.7) 64,000 7.1 (5.4−9.5)
Texas 1,880,000 70.2 (66.4−73.7) 386,000 14.4 (11.9−17.3) 215,000 8.0 (6.1−10.6)
Utah 264,000 67.4 (65.1−69.7) 42,000 10.8 (9.4−12.4) 36,000 9.3 (7.9−10.8)
Vermont 64,000 72.0 (68.8−75.1) 11,000 12.8 (10.8−15.0) 5,000 5.5 (3.9−7.5)
Virginia 765,000 70.0 (67.3−72.7) 130,000 11.9 (10.2−13.8) 68,000 6.3 (5.1−7.7)
Washington 739,000 71.1 (68.9−73.2) 177,000 17.1 (15.4−18.9) 65,000 6.2 (5.3−7.4)
West Virginia 237,000 68.4 (65.3−71.3) 35,000 10.1 (8.3−12.2) 18,000 5.3 (4.0−7.0)
Wisconsin 605,000 74.2 (70.8−77.3) 123,000 15.0 (12.6−17.8) 54,000 6.6 (5.0−8.8)
Wyoming 51,000 70.0 (65.8−73.8) 8,000 11.4 (9.0−14.4) 5,000 7.3 (5.3−10.2)
Median (49 states and District of Columbia) 70.5 12.6 7.1
Guam 6,000 57.8 (47.2−67.8) 2,000 25.2 (15.5−38.3) 1,000 11.9 (7.4−18.8)
Puerto Rico 153,000 68.3 (63.5−72.8) 22,000 9.8 (7.3−13.0) 3,000 ††

Table 3. Unadjusted reported prevalence of walking, gardening, or weightlifting as a first or second most frequent activity* among adults with arthritis who reported engaging in physical activity in the past month§ — Behavioral Risk Factor Surveillance System, United States, 2019

Abbreviation: CI = confidence interval.

* Adults engaging in physical activity were classified as participating in an activity if they reported this activity for one of two questions: 1) “What type of physical activity or exercise did you spend the most time doing during the past month?” or 2) “What other type of physical activity gave you the next most exercise during the past month?” Participants who reported one activity but had missing data for the other most frequent activity (e.g., “don’t know,” or “refused”) were included in the analysis.

Respondents were classified as having arthritis if they responded “yes” to the question, “Have you ever been told by a doctor or other health care provider that you have arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?”

§ Respondents with arthritis were classified as engaging in physical activity if they responded “yes” to the question, “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?”

In 2019, New Jersey did not collect enough data to meet the minimum requirement for inclusion in the BRFSS public-use data set.

** Weighted number represents the estimated number of adults with arthritis engaging in physical activity who reported the activity (walking, gardening, or weightlifting) as their first or second most frequent activity.

†† Unreliable estimate (relative standard error >30%).

CME / ABIM MOC / CE

Walking and Other Common Physical Activities Among Adults With Arthritis — United States, 2019

  • Authors: Dana Guglielmo, MPH; Louise B. Murphy, PhD; Kristina A. Theis, PhD; Michael A. Boring, MS; Charles G. Helmick, MD; Kathleen B. Watson, PhD; Lindsey M. Duca, PhD; Erica L. Odom, DrPH; Yong Liu, MD; Janet B. Croft, PhD
  • CME / ABIM MOC / CE Released: 12/22/2021
  • THIS ACTIVITY HAS EXPIRED
  • Valid for credit through: 12/22/2022
Start Activity


Target Audience and Goal Statement

This activity is intended for public health officials, rheumatologists, internists, family practitioners, orthopedists, nurses, and other clinicians caring for patients with arthritis.

The goal of this activity is to describe the most common nonwork-related physical activities among US adults with arthritis who reported any physical activity during the past month, nationally and by state, according to a Centers for Disease Control and Prevention (CDC) analysis of 2019 Behavioral Risk Factor Surveillance System (BRFSS) data.

Upon completion of this activity, participants will:

  • Describe the most common non--work-related physical activities among US adults with arthritis who reported any physical activity during the past month, nationally and by state, according to a Centers for Disease Control and Prevention (CDC) analysis of 2019 Behavioral Risk Factor Surveillance System (BRFSS) data
  • Determine benefits and other considerations regarding the most common nonwork-related physical activities among US adults with arthritis who reported any physical activity during the past month, nationally and by state, according to a CDC analysis of 2019 BRFSS data
  • Identify recommendations for clinicians regarding improving their patients’ participation in physical activities and other clinical implications of these findings from a CDC analysis of 2019 BRFSS data


Disclosures

As an organization accredited by the ACCME, Medscape, LLC requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


Faculty

  • Dana Guglielmo, MPH

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia
    Oak Ridge Institute for Science and Education
    Oak Ridge, Tennessee

    Disclosures

    Disclosure: Dana Guglielmo, MPH, has disclosed no relevant financial relationships.

  • Louise B. Murphy, PhD

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Louise B. Murphy, PhD, has disclosed no relevant financial relationships.

  • Kristina A. Theis, PhD

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Kristina A. Theis, PhD, has disclosed no relevant financial relationships.

  • Michael A. Boring, MS

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Michael A. Boring, MS, has disclosed no relevant financial relationships.

  • Charles G. Helmick, MD

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Charles G. Helmick, MD, has disclosed no relevant financial relationships.

  • Kathleen B. Watson, PhD

    Division of Nutrition, Physical Activity, and Obesity
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Kathleen B. Watson, PhD, has disclosed no relevant financial relationships.

  • Lindsey M. Duca, PhD

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Epidemic Intelligence Service
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Lindsey M. Duca, PhD, has disclosed no relevant financial relationships.

  • Erica L. Odom, DrPH

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Erica L. Odom, DrPH, has disclosed no relevant financial relationships.

  • Yong Liu, MD

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Yong Liu, MD, has disclosed no relevant financial relationships.

  • Janet B. Croft, PhD

    Division of Population Health
    National Center for Chronic Disease Prevention and Health Promotion
    Centers for Disease Control and Prevention (CDC)
    Atlanta, Georgia

    Disclosures

    Disclosure: Janet B. Croft, PhD, has disclosed no relevant financial relationships.

CME Author

  • Laurie Barclay, MD

    Freelance writer and reviewer
    Medscape, LLC

    Disclosures

    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

CME Reviewer/Nurse Planner

  • Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP

    Associate Director, Accreditation and Compliance
    Medscape, LLC

    Disclosures

    Disclosure: Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP, has disclosed no relevant financial relationships.

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CME / ABIM MOC / CE

Walking and Other Common Physical Activities Among Adults With Arthritis — United States, 2019

Authors: Dana Guglielmo, MPH; Louise B. Murphy, PhD; Kristina A. Theis, PhD; Michael A. Boring, MS; Charles G. Helmick, MD; Kathleen B. Watson, PhD; Lindsey M. Duca, PhD; Erica L. Odom, DrPH; Yong Liu, MD; Janet B. Croft, PhDFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED

CME / ABIM MOC / CE Released: 12/22/2021

Valid for credit through: 12/22/2022

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Introduction

The numerous health benefits of physical activity include reduced risk for chronic disease and improved mental health and quality of life [1]. Physical activity can improve physical function and reduce pain and fall risk among adults with arthritis, a group of approximately 100 conditions affecting joints and surrounding tissues (most commonly osteoarthritis, fibromyalgia, gout, rheumatoid arthritis, and lupus) [1]. Despite these benefits, the 54.6 million U.S. adults currently living with arthritis are generally less active than adults without arthritis, and only 36.2% of adults with arthritis are aerobically active (i.e., meet aerobic physical activity guidelines*) [2]. Little is known about which physical activities adults with arthritis engage in. CDC analyzed 2019 Behavioral Risk Factor Surveillance System (BRFSS) data to examine the most common nonwork–related physical activities among adults with arthritis who reported any physical activity during the past month, nationally and by state. In 2019, 67.2% of adults with arthritis reported engaging in physical activity in the past month; among these persons, the most commonly reported activities were walking (70.8%), gardening (13.3%), and weightlifting (7.3%). In 45 U.S. states, at least two thirds of adults with arthritis who engaged in physical activity reported walking. Health care providers can help inactive adults with arthritis become active and, by encouraging physical activity and referring these persons to evidence-based physical activity programs, improve their health and quality of life.

BRFSS is an ongoing, state-based landline and cellular telephone survey of noninstitutionalized U.S. adults aged ≥18 years conducted by health departments in 50 states, the District of Columbia (DC), and U.S. territories. In 2019, the median response rate among the 49 states included in this analysis§ was 49.4% (range = 37.3%–73.1%). Arthritis was defined as an affirmative response to the question, “Have you ever been told by a doctor or other health care professional that you have arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?”** Engaging in physical activity was defined as responding “yes” to the question, “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?” Among the 380,418 (92.8%) BRFSS respondents in 49 states and DC who reported arthritis status, age, and physical activity status, 87,299 (22.9%) reported having arthritis and engaging in physical activity. These participants were asked to report up to two activities in which they most frequently engaged from a list of 74 activities.††

Unadjusted percentages for each activity were calculated for the combined 49 states and DC. Age-specific and age-adjusted§§ percentages for the three most commonly reported activities (walking, gardening, and weightlifting) were calculated for adults with arthritis engaging in nonwork–related physical activity by selected sociodemographic and health-related characteristics, including joint pain severity, body mass index, physical limitations, and self-rated health. Unadjusted state-specific prevalences of walking, gardening, and weightlifting among adults with arthritis were also estimated. Paired t-tests were performed to assess differences across subgroups for all variables, and linear trend tests using orthogonal linear contrasts were conducted for ordinal variables; all comparisons reported are statistically significant (p-value <0.05). Analyses accounted for BRFSS’s complex sampling design, were weighted to be representative of each state, and were conducted using SAS (version 9.4; SAS Institute) and SUDAAN (version 11.0; RTI International). This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.¶¶

In 2019, 67.2% of adults with arthritis engaged in nonwork–related physical activity in the past month; walking was the most commonly reported activity (70.8%), followed by gardening (13.3%), and weightlifting (7.3%) (Table 1). The percentage reporting walking was lowest among those 18–44 years (63.7%) (Table 2) . The age-adjusted prevalence of walking was higher among women (76.0%) than among men (63.9%), higher among non-Hispanic Black (75.4%) adults than among non-Hispanic White (70.0%) and non-Hispanic other/multiple race adults (68.3%), and higher among those who were unable to work or disabled (79.0%) compared with those adults with other employment statuses (67.7%–74.8%). The age-adjusted percentage of adults with arthritis who reported walking increased with increasing joint pain severity and body mass index, and decreased with increasing education, income, and self-rated health.

The percentage of adults with arthritis who reported gardening increased with age from 7.0% among adults aged 18–44 years to 16.4% among those aged ≥65 years. The age-adjusted prevalence of gardening was higher among women (15.1%) than among men (10.9%), and higher among non-Hispanic White adults (14.4%) than among non-Hispanic American Indian/Alaska Native adults (8.0%) and non-Hispanic Black adults (7.8%). The percentage reporting gardening was lower among those without a high school diploma (10.5%) than among persons with higher levels of educational attainment (12.7%–14.5%). Gardening prevalence increased with increasing rurality.

The prevalence of weightlifting was highest among those aged 18–44 years (12.3%), declined with age, and was higher among men (10.9%) than among women (4.7%) and higher among those who were employed or self-employed (9.2%) than among those who were unable to work or disabled (2.1%). Weightlifting prevalence increased with increasing education, income, and self-rated health and decreased with increasing joint pain severity and rurality.

The median state-specific unadjusted percentage of adults with arthritis who reported walking was 70.5% (range = 62.9% [Hawaii] to 75.4% [Alabama]) (Table 3) . The median percentage who reported gardening was 12.6% (range = 3.8% [DC] to 17.6% [Florida], and the median who reported weightlifting was 7.1% (range = 3.6% [Maine] to 13.9% [DC]).

____

* The earlier study used the 2008 Physical Activity Guidelines for Americans (https://health.gov/sites/default/files/2019-09/paguide.pdf ), which are equivalent to the most recent (2018) Physical Activity Guidelines for Americans, 2nd Ed. https://health.gov/sites/default/files/2019-09/Physical_Activity_ Guidelines_2nd_edition.pdf

https://www.cdc.gov/brfss/about/index.htm

§ This analysis included 49 states and the District of Columbia. In 2019, New Jersey did not collect enough data to meet the minimum requirement for inclusion in the BRFSS public-use data set.

https://www.cdc.gov/brfss/annual_data/2019/pdf/2019-sdqr-508.pdf

** https://www.cdc.gov/arthritis/basics/types.html

†† A specific activity was counted once if it was reported in response to one of the following questions: “What type of physical activity or exercise did you spend the most time doing during the past month?” or “What other type of physical activity gave you the next most exercise during the past month?” Participants who reported one activity but had missing data for the second most frequent activity (e.g., “don’t know” or “refused”) were included in the analysis. Among 87,299 adults with arthritis engaging in physical activity, 77,733 participants answered at least the first question (7,859 reported “Don’t know,” 366 refused, and 1,341 responses were missing). The 74 activities were organized into major headings using a modified version of the 2011 Compendium of Physical Activities by Ainsworth et al. (https://cdn-links. lww.com/permalink/mss/a/mss_43_8_2011_06_13_ainsworth_202093_ sdc1.pdf ). Activities were grouped on the basis of similarity and on resporonment barriers to walking by providing safe and supportive infrastructures such as sidewalks, benches, and green spaces.¶¶¶ Promoting engagement in physical activity among adults with arthritis can reduce their risk for chronic health conditions and improve their mental health and quality of life.nse rates, with activities having <400 respondents combined into “Other” categories corresponding to the major headings.

§§ Age-adjusted estimates were generated in weighted logistic regression models that included age as a categorical covariate (18−44 years, 45−64 years, and ≥65 years).

¶¶ 45 C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.