EXERCISE PRACTICES IN SOUTH ASIAN COMMUNITIES WITH OSTEOARTHRITIS: A SCOPING REVIEW

Document Type

Conference Proceeding

Publication Date

6-1-2024

Publication Title

Osteoarthritis Cartilage

Abstract

Purpose (the aim of the study): Osteoarthritis (OA) is a common chronic disease with a significant impact on South Asian (SA) populations, where reports of OA prevalence range widely and reach up to 83%. Given the demonstrated benefits of exercise on OA outcomes, we aimed to conduct a scoping review to explore the current state of the literature on exercise practices among SA individuals living with OA; these communities' unique cultural norms may impact health-related behaviors associated with exercise interventions. Methods: We conducted a scoping review and used a mixed methods approach for data analysis. Our literature search spanned the databases Medline, Embase, PsycINFO, PubMed, and the Sports Medicine & Education Index, focusing on peer-reviewed studies published between 2007 and 2022. We selected studies that expressly reported on ‘exercise’ in the context of OA management. ‘South Asian populations’ refer to individuals from Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-SCr) criteria. We used Covidence software for deduplication, screening (by two independent reviewers), and data extraction. Disputes over study selection were handled through consensus or by consulting a third reviewer. Our analysis included quantitative assessments (capturing countries, exercise types, study types, and measurement tools) as well as qualitative methods, with an emphasis on inductive coding to allow themes to emerge directly from the data. We also compared our findings to the exercise recommendations outlined in the 2019 guideline for the management of OA. Results: Our literature search returned 678 records, with 434 titles and abstracts screened after removing duplicates. From this, 54 full-text articles were screened, and 33 articles were determined to meet our selection criteria. The majority of included articles were from India (22 of 33), with studies focused primarily on resistance-based exercises (21 of 33), and predominantly using randomized controlled trials with the Western Ontario and McMaster Universities Arthritis Index (WOMAC) as the most common outcome measure. Notably, the language in which the WOMAC was administered was not explicitly stated. Our content analysis identified four overarching themes. First, 'Perception of Illness and Exercise' reflects how SA communities’ cultural beliefs on OA (particularly with respect to pain) influence their exercise habits and attitudes. Second, 'Yoga as a Prevalent Exercise Practice' emphasizes the common use of yoga for managing OA in these cultural groups. Third, 'Cultural Nuances in Research Design' captures the role of cultural factors in defining research methodology and exercises selected for OA management. Fourth, 'Accessibility & Personalized OA Management' identifies the need for tailored exercise regimens that are readily integrated into daily routines of SA communities (e.g., simple stretching or strength-building exercises that can be done while performing activities of daily living, not requiring specialized equipment or settings). Finally, we found that the exercises reported in the included articles were generally consistent with those recommended in established OA management guidelines, with a focus on preferred exercises such as yoga. Conclusions: This scoping review revealed four key findings that highlight important effects of cultural norms on exercise interventions for OA management in SA populations: 'Perception of Illness and Exercise', 'Yoga as a Prevalent Exercise Practice', 'Cultural Nuances in Research Design', and 'Accessibility & Personalized OA Management'. Taken together, these findings emphasize the need to tailor exercise interventions to the specific health perspectives and preferences held by a cultural group. Our findings are most relevant to Indian populations since the majority of included studies were conducted in India. Our findings also highlight the need for more researc into the cultural adaptation of outcome measures such as WOMAC, specifically its linguistic suitability for SA communities, to improve studies on OA management in diverse cultural contexts. Ultimately, a better understanding of the cultural norms surrounding exercise practices is expected to inform more appropriate interventions to improve OA management in SA populations.

Volume

32

Issue

6

First Page

824-825

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