Abstract

Objective: Osteoarthritis (OA) is a multifactorial degenerative disease characterized by a range of morphological and biochemical alterations to the joint capsule and synovial membrane, as well as bone hypertrophy and articular cartilage loss at the margins. Osteoarthritis (OA) is one of the most common causes of impairment in adults. This review aims to determine whether knee osteoarthritis and the state of cardiorespiratory health are correlated. Reviewing the relationship between knee osteoarthritis (OA) and cardiorespiratory health status is important because OA’s systemic effects are becoming more well-acknowledged. To improve quality of life and lessen the strain on healthcare systems, comprehensive management strategies that address not only joint health but also an individual’s total cardiovascular and respiratory well-being must take this relationship into account. Study design: Research articles were retrieved for this systematic review from reliable academic search engines such as Google Scholar, IEEE Xplore, Springer, and Elsevier. To obtain answers to the research questions, appropriate keywords are utilized in the literature search from reputable sources, such as Web of Science (WOS), and Scopus. The current study includes 80 papers. They underwent an extensive evaluation using the Prisma methodology for systematic review. Result and conclusion: Given that there is a favourable link between knee osteoarthritis (OA) and cardiorespiratory health status, this review has the potential to revolutionize the management of OA by promoting a more exhaustive treatment approach. Cardiorespiratory fitness assessments may be incorporated by medical professionals into standard OA treatment, resulting in specific therapies that promote cardiovascular and joint health. This may lead to increased cardiovascular health, increased mobility, and better overall patient outcomes, which would eventually save healthcare expenses and raise the standard of living for those who have osteoarthritis.

• 1.   Madry, H., Luyten, F.P., & Facchini, A. (2012). Biological aspects of early osteoarthritis.cKnee surgery, sports traumatology, arthroscopy, 20, 407-422.
• 2.   McDonough, C.M., & Jette, A.M. (2010). The contribution of osteoarthritis to functional limitations and disability. Clinics in geriatric medicine, 26(3), 387-399.
• 3.   Machado, G.P., Gignac, M.A., & Badley, E.M. (2008). Participation restrictions among older adults with osteoarthritis: a mediated model of physical symptoms, activity limitations, and depression. Arthritis Care & Research: Official Journal of the American College of Rheumatology, 59(1), 129-135.
• 4.   Jones, N.L., & Killian, K.J. (2000). Exercise limitation in health and disease. New England Journal of Medicine, 343(9), 632-641.
• 5.   Vogiatzis, I., Zakynthinos, G., & Andrianopoulos, V. (2012). Mechanisms of physical activity limitation in chronic lung diseases. Pulmonary medicine, 2012(1), 634761.
• 6.   Jones, N.L., & Killian, K.J. (2000). Exercise limitation in health and disease. New England Journal of Medicine, 343(9), 632-641.
• 7.   Vincent, K.R., Conrad, B.P., Fregly, B.J., & Vincent, H.K. (2012). The pathophysiology of osteoarthritis: a mechanical perspective on the knee joint. PM&R, 4(5), S3-S9.
• 8.   Wise, B.L., Niu, J., Yang, M., Lane, N.E., Harvey, W., Felson, D.T., ... & Multicenter Osteoarthritis (MOST) Group. (2012). Patterns of compartment involvement in tibiofemoral osteoarthritis in men and women and in whites and African Americans. Arthritis care & research, 64(6), 847-852.
• 9.   Lawrence, R.C., Felson, D.T., Helmick, C.G., Arnold, L. M., Choi, H., Deyo, R. A., ... & National Arthritis Data Workgroup. (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis & Rheumatism, 58(1), 26-35.
• 10.   Raghuveer, G., Hartz, J., Lubans, D.R., Takken, T., Wiltz, J. L., Mietus-Snyder, M., ... & American Heart Association Young Hearts Athero, Hypertension and Obesity in the Young Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young. (2020). Cardiorespiratory fitness in youth: an important marker of health: a scientific statement from the American Heart Association. Circulation, 142(7), e101-e118.
• 11.   Mesa, J.L., Ortega, F.B., Ruiz, J.R., Castillo, M.J., Hurtig-Wennlöf, A., Sjöström, M., & Gutiérrez, Á. (2006). The importance of cardiorespiratory fitness for healthy metabolic traits in children and adolescents: the AVENA Study. Journal of Public Health, 14, 178-180.
• 12.   Kaminsky, L.A., Arena, R., Ellingsen, Ø., Harber, M. P., Myers, J., Ozemek, C., & Ross, R. (2019). Cardiorespiratory fitness and cardiovascular disease-the past, present, and future. Progress in cardiovascular diseases, 62(2), 86-93.
• 13.   Kaminsky, L.A., Arena, R., Beckie, T.M., Brubaker, P.H., Church, T.S., Forman, D.E., ... & Williams, M. A. (2013). The importance of cardiorespiratory fitness in the United States: the need for a national registry: a policy statement from the American Heart Association. Circulation, 127(5), 652-662.
• 14.   McDonough, C.M., & Jette, A.M. (2010). The contribution of osteoarthritis to functional limitations and disability. Clinics in geriatric medicine, 26(3), 387-399.
• 15.   Shaheen, A.M., & Ayad, K. (2008). Impact of chronic osteoarthritis of knee joint on postural stability and functional mobility in women. Bull Fac Ph Th Cairo Univ, 13, 19-33.
• 16.   Brody, L.T. (2015). Knee osteoarthritis: clinical connections to articular cartilage structure and function. Physical Therapy in Sport, 16(4), 301-316.
• 17.   Saxon, S.V., Etten, M.J., Perkins, E.A., & RNLD, F. (2021). Physical change and aging: A guide for helping professions. Springer Publishing Company.
• 18.   Palmer, K.L. (2024). Pain, well-being, and physical activity in adults with chronic pain and spinal cord injury (Doctoral dissertation, University of British Columbia).
• 19.   De Groot, I.B., Bussmann, J.B., Stam, H.J., & Verhaar, J.A.N. (2008). Actual everyday physical activity in patients with end-stage hip or knee osteoarthritis compared with healthy controls. Osteoarthritis and cartilage, 16(4), 436-442.
• 20.   Rosemann, T., Kuehlein, T., Laux, G., & Szecsenyi, J. (2008). Factors associated with physical activity of patients with osteoarthritis of the lower limb. Journal of evaluation in clinical practice, 14(2), 288- 293.
• 21.   Shih, M., Hootman, J.M., Kruger, J., & Helmick, C. G. (2006). Physical activity in men and women with arthritis: National Health Interview Survey, 2002. American journal of preventive medicine, 30(5), 385-393.
• 22.   White, D.K., Tudor-Locke, C., Zhang, Y., Fielding, R., LaValley, M., Felson, D.T., ... & Neogi, T. (2014). Daily walking and the risk of incident functional limitation in knee osteoarthritis: an observational study. Arthritis care & research, 66(9), 1328-1336.
• 23.   van Dijk, G.M., Veenhof, C., Lankhorst, G.J., & Dekker, J. (2009). Limitations in activities in patients with osteoarthritis of the hip or knee: the relationship with body functions, comorbidity and cognitive functioning. Disability and rehabilitation, 31(20), 1685-1691.
• 24.   Rosemann, T., Kuehlein, T., Laux, G., & Szecsenyi, J. (2007). Osteoarthritis of the knee and hip: a comparison of factors associated with physical activity. Clinical rheumatology, 26, 1811-1817.
• 25.   Thompson, P.D., Buchner, D., Piña, I.L., Balady, G. J., Williams, M. A., Marcus, B. H., ... & Wenger, N. K. (2003). Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation, 107(24), 3109-3116.
• 26.   Spruit, M.A., Singh, S.J., Garvey, C., ZuWallack, R., Nici, L., Rochester, C., ... & Wouters, E.F. (2013). An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. American journal of respiratory and critical care medicine, 188(8), e13-e64.
• 27.   Nici, L., Donner, C., Wouters, E., Zuwallack, R., Ambrosino, N., Bourbeau, J., ... & Troosters, T. (2006). American thoracic society/European respiratory society statement on pulmonary rehabilitation. American journal of respiratory and critical care medicine, 173(12), 1390-1413.
• 28.   Richter, M.J., Grimminger, J., Krüger, B., Ghofrani, H.A., Mooren, F.C., Gall, H., ... & Krüger, K. (2017). Effects of exercise training on pulmonary hemodynamics, functional capacity and inflammation in pulmonary hypertension. Pulmonary circulation, 7(1), 20-37.
• 29.   Belanger, M.J., Rao, P., & Robbins, J.M. (2022). Exercise, physical activity, and cardiometabolic health: Pathophysiologic insights. Cardiology in review, 30(3), 134-144.
• 30.   Bouchard, D.R., McGuire, K.A., Davidson, L., & Ross, R. (2011). Cardiorespiratory fitness, obesity, and functional limitation in older adults. Journal of aging and physical activity, 19(4), 336-346.
• 31.   Park, D., Park, Y. M., Ko, S. H., Choi, Y.H., Min, D.U., Ahn, J.H., ... & Han, K. (2023). Association between knee osteoarthritis and the risk of cardiovascular disease and the synergistic adverse effects of lack of exercise. Scientific Reports, 13(1), 2777.
• 32.   Sutbeyaz, S.T., Sezer, N., Koseoglu, B.F., Ibrahimoglu, F., & Tekin, D. (2007). Influence of knee osteoarthritis on exercise capacity and quality of life in obese adults. Obesity, 15(8), 2071-2076.
• 33.   Steele, B.E. (2013). Aerobic Capacity in Individuals with Osteoarthritis of the Knee(Doctoral dissertation, Auckland University of Technology).
• 34.   Kalantri, G., & Shewale, S. (2021). Cardiovascular endurance among community dwelling elderly population with oa knee-cross sectional study. Vims journal of physical therapy, 3(1), 23-27.
• 35.   Øiestad, B.E., Årøen, A., Røtterud, J.H., Østerås, N., Jarstad, E., Grotle, M., & Risberg, M.A. (2023). The long-term efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial.
• 36.   Carvalho, M.R.P.D., Sato, E.I., Tebexreni, A.S., Heidecher, R.T., Schenkman, S., & Neto, T.L. B. (2005). Effects of supervised cardiovascular training program on exercise tolerance, aerobic capacity, and quality of life in patients with systemic lupus erythematosus. Arthritis Care & Research: Official Journal of the American College of Rheumatology, 53(6), 838-844.
• 37.   Zhong, Y.J., Meng, Q., & Su, C.H. (2024). Mechanism-Driven Strategies for Reducing Fall Risk in the Elderly: A Multidisciplinary Review of Exercise Interventions.
• 38.   Gangwar, D. Mobility and Strength Training in Older Adults. Physiotherapy in Geriatric Condition, 139.
• 39.   Gibson, A. L., Wagner, D. R., & Heyward, V. H. (2024). Advanced fitness assessment and exercise prescription. Human kinetics.
• 40.   Dean, E., & Gormsen Hansen, R. (2012). Prescribing Optimal Nutrition and Physical Activity as “First-Line” Interventions for Best Practice Management of Chronic Low-Grade Inflammation Associated with Osteoarthritis: Evidence Synthesis. Arthritis, 2012(1), 560634.
• 41.   Skou, S.T., Pedersen, B.K., Abbott, J.H., Patterson, B., & Barton, C. (2018). Physical activity and exercise therapy benefit more than just symptoms and impairments in people with hip and knee osteoarthritis. Journal of orthopaedic & sports physical therapy, 48(6), 439-447.
• 42.   Maly, M.R., Marriott, K.A., & Chopp-Hurley, J. N. (2020). Osteoarthritis year in review 2019: rehabilitation and outcomes. Osteoarthritis and cartilage, 28(3), 249-266.
• 43.   Herbolsheimer, F. (2017). A physically active lifestyle in old age: the role of the physical and social environment (Doctoral dissertation, Universität Ulm).
• 44.   Odom, E.L. (2015). The cost of inactivity: differences in total healthcare expenditures and healthcare service utilization between sedentary and active adults with arthritis (Doctoral dissertation, University of Georgia).
• 45.   Hootman, J.M., Helmick, C.G., & Brady, T.J. (2012). A public health approach to addressing arthritis in older adults: the most common cause of disability. American journal of public health, 102(3), 426-433.
• 46.   Ekelund, L.G., Haskell, W.L., Johnson, J.L., Whaley, F.S., Criqui, M.H., Sheps, D.S., & Lipid Research Clinics Mortality Follow-up Study. (1988). Physical fitness as a predictor of cardiovascular mortality in asymptomatic North American men. New England Journal of Medicine, 319(21), 1379-1384.
• 47.   Loew, L., Brosseau, L., Wells, G.A., Tugwell, P., Kenny, G.P., Reid, R., ... & Coyle, D. (2012). Ottawa panel evidence-based clinical practice guidelines for aerobic walking programs in the management of osteoarthritis. Archives of physical medicine and rehabilitation, 93(7), 1269-1285.
• 48.   De Angelis, G. (2012). The cost-effectiveness of an adapted community-based aerobic walking program for individuals with mild or moderate osteoarthritis of the knee. University of Ottawa (Canada).

Data Sharing Statement

Funding