Previous research has shown that exercise is an effective way of managing osteoarthritis for older adults. However, surveys also reveal that older adults with osteoarthritis are a particularly sedentary segment of the population. One survey showed that 40 percent of men and 50 percent of women with knee osteoarthritis are entirely inactive. While physical factors certainly play a role in the activity levels of individuals with osteoarthritis, there are also psychological barriers to engaging in likely beneficial exercise behaviors. Researchers suggest that one such psychological barrier is that older adults feel like they have less control over their health and physical functioning as they age. In a number of studies, a sense of control has been associated with better physical functioning and better psychological health, as well as higher life satisfaction and lower depressive symptoms. An important question is how to get older adults to perceive that they have greater control over their health and physical functioning. In light of both the benefits of exercise and the benefits of having a greater sense of control, a recent study in the Gerontologist looks at the role exercise intention may play.
When looking at exercise intention, researchers reviewed how certain the individuals with osteoarthritis were that they would complete seven types of physical tasks, ranging from heavy or light housework to light or strenuous sports or exercise. The researchers measured the relationship of exercise intention to the subjects’ perceptions of the two primary aspects of a sense of control: mastery in ability to perform tasks (“I can do anything I really set my mind to”), and the constraints that may prevent completion of tasks (“I have little control over the things that happen to me”). When exercise intention was examined in relation to perceived mastery and constraints, researchers found that exercise intention was positively associated with both higher perceived mastery and lower perceived constraints. Looked at over time, higher exercise intention predicted fewer perceived constraints one year later. Importantly, this effect was seen even when pain was taken into account. This suggests that the sense of control is not merely related to an ability to do more as a result of having lower levels of pain.
Since higher perceived constraints are associated with poorer health and well-being, the authors suggest that targeting exercise intention could be an effective intervention that could prove protective for health. This benefit would come not only from the physical benefits of exercise, but also from the psychological impact of perceiving fewer constraints. Moreover, targeting exercise intention has the benefit of providing concrete activities and goals that an intervention can instruct older adults to target.
Cotter KA and Sherman AM. Exercising control: exercise intention and perceived constraints in older adults with osteoarthritis. The Gerontologist (2013); 53: 1046–1050.