title: Role of exercise for knee pain: what do older adults in the community think?
abstract: OBJECTIVE
  Older adults with knee pain report low levels of exercise and physical activity. One explanation for this might be that they believe exercise is unhelpful or even harmful for knee pain. We therefore explored the attitudes and beliefs of older adults in the community about the role of exercise for knee pain using mixed methods.
  
  
  METHODS
  A survey was mailed to 2,234 older adults registered with 1 general practice within the UK. The survey included 23 attitude statements derived from published exercise recommendations. Semistructured interviews were completed in a purposeful sample of questionnaire responders (n = 22) and were recorded and analyzed thematically.
  
  
  RESULTS
  The questionnaire response rate was 59% (n = 1,276), and 611 respondents reported knee pain in the past 12 months. There was considerable uncertainty about the benefits of exercise; <50% largely or totally agreed on any attitude statement relating to the benefit of exercise for knee pain. The interviews revealed that attitudes and beliefs about exercise for knee pain are linked to the individuals' perceptions about their knee problems, and that many different barriers and facilitators to exercise and physical activity exist. These barriers and facilitators could be grouped as those relating to the person, the knee problem itself, and social or environmental factors. Barriers and facilitators varied between different individuals and over time.
  
  
  CONCLUSIONS
  The overall uncertainty within the community about the role of exercise for knee pain highlights the challenges faced by those living with knee pain in completing physical activity, and for health care professionals prescribing exercise for this patient group.
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK. m.holden@cphc.keele.ac.uk
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Holden
authors.forename: Elaine E
authors.initials: EE
authors.lastname: Nicholls
authors.forename: Julie
authors.initials: J
authors.lastname: Young
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Hay
authors.forename: Nadine E
authors.initials: NE
authors.lastname: Foster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000534:rehabilitation*; D010146:Pain / Q000534:rehabilitation*; D011795:Surveys and Questionnaires