Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met?

OBJECTIVE Osteoarthritis (OA) clinical practice guidelines identify a substantial therapeutic role for physical activity, but objective information about the physical activity of this population is lacking. The aim of this study was to objectively measure levels of physical activity in adults with knee OA and report the prevalence of meeting public health physical activity guidelines. METHODS Cross-sectional accelerometry data from 1,111 adults with radiographic knee OA (49-84 years old) participating in the Osteoarthritis Initiative accelerometry monitoring ancillary study were assessed for meeting the aerobic component of the 2008 Physical Activity Guidelines for Americans (≥150 minutes/week moderate-to-vigorous-intensity activity lasting ≥10 minutes). Quantile regression was used to test median sex differences in physical activity levels. RESULTS Aerobic physical activity guidelines were met by 12.9% of men and 7.7% of women with knee OA. A substantial proportion of men and women (40.1% and 56.5%, respectively) were inactive, having done no moderate-to-vigorous activity that lasted 10 minutes or more during the 7 days. Although men engaged in significantly more moderate-to-vigorous activity (average daily minutes 20.7 versus 12.3), they also spent more time in no or very-low-intensity activity than women (average daily minutes 608.2 versus 585.8). CONCLUSION Despite substantial health benefits from physical activity, adults with knee OA were particularly inactive based on objective accelerometry monitoring. The proportions of men and women who met public health physical activity guidelines were substantially less than those previously reported based on self-reported activity in arthritis populations. These findings support intensified public health efforts to increase physical activity levels among people with knee OA.

[1]  Rowland W Chang,et al.  Assessing physical activity in persons with rheumatoid arthritis using accelerometry. , 2010, Medicine and science in sports and exercise.

[2]  L. Mâsse,et al.  Physical activity in the United States measured by accelerometer. , 2008, Medicine and science in sports and exercise.

[3]  M. Heo,et al.  Are US adults with arthritis meeting public health recommendations for physical activity? , 2004, Arthritis and rheumatism.

[4]  M. Hamilton,et al.  Exercise Physiology versus Inactivity Physiology: An Essential Concept for Understanding Lipoprotein Lipase Regulation , 2004, Exercise and sport sciences reviews.

[5]  Thomas J. Schnitzer,et al.  Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update , 2000 .

[6]  Scott B Going,et al.  Physical activity levels in patients with early knee osteoarthritis measured by accelerometry. , 2008, Arthritis and rheumatism.

[7]  J. Robins,et al.  Analysis of semiparametric regression models for repeated outcomes in the presence of missing data , 1995 .

[8]  A. King,et al.  Moderate-Intensity Exercise and Self-rated Quality of Sleep in Older Adults: A Randomized Controlled Trial , 1997 .

[9]  David R Bassett,et al.  Sources of variance in daily physical activity levels as measured by an accelerometer. , 2002, Medicine and science in sports and exercise.

[10]  Stewart G Trost,et al.  Conducting accelerometer-based activity assessments in field-based research. , 2005, Medicine and science in sports and exercise.

[11]  C Kent Kwoh,et al.  Assessing physical activity in persons with knee osteoarthritis using accelerometers: Data from the osteoarthritis initiative , 2010, Arthritis care & research.

[12]  B E Ainsworth,et al.  Estimation of energy expenditure from physical activity measures: determinants of accuracy. , 2001, Obesity research.

[13]  C. Helmick,et al.  Physical activity levels among the general US adult population and in adults with and without arthritis. , 2003, Arthritis and rheumatism.

[14]  Atlanta,et al.  Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. , 2008, Arthritis and rheumatism.

[15]  Joseph W Hogan,et al.  Handling drop‐out in longitudinal studies , 2004, Statistics in medicine.

[16]  W. Harris,et al.  Can the western Ontario and McMaster Universities (WOMAC) osteoarthritis index be used to evaluate different hip joints in the same patient? , 1996, The Journal of arthroplasty.

[17]  B E Ainsworth,et al.  Compendium of physical activities: an update of activity codes and MET intensities. , 2000, Medicine and science in sports and exercise.

[18]  Michael E. Miller,et al.  Exercise and depressive symptoms: a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. , 2002, The journals of gerontology. Series B, Psychological sciences and social sciences.

[19]  Margaret Shih,et al.  Physical activity in men and women with arthritis National Health Interview Survey, 2002. , 2006, American journal of preventive medicine.

[20]  G. Lester,et al.  Clinical research in OA--the NIH Osteoarthritis Initiative. , 2008, Journal of musculoskeletal & neuronal interactions.

[21]  C. Goldsmith,et al.  Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. , 1988, The Journal of rheumatology.

[22]  J. Shaw,et al.  Objectively Measured Sedentary Time, Physical Activity, and Metabolic Risk , 2007, Diabetes Care.

[23]  Barbara E Ainsworth,et al.  Comparison of energy expenditure estimates from doubly labeled water, a physical activity questionnaire, and physical activity records. , 2002, The American journal of clinical nutrition.

[24]  Yves Schutz,et al.  The use of uniaxial accelerometry for the assessment of physical-activity-related energy expenditure: a validation study against whole-body indirect calorimetry. , 2004, The British journal of nutrition.

[25]  G. Welk,et al.  Reliability of accelerometry-based activity monitors: a generalizability study. , 2004, Medicine and science in sports and exercise.

[26]  Moshe Buchinsky Recent Advances in Quantile Regression Models: A Practical Guideline for Empirical Research , 1998 .

[27]  J. Keysor,et al.  Does late-life physical activity or exercise prevent or minimize disablement? A critical review of the scientific evidence. , 2003, American journal of preventive medicine.

[28]  W. Applegate,et al.  A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). , 1997, JAMA.

[29]  Timothy E. McAlindon,et al.  Osteoarthritis: New Insights , 2002 .

[30]  Carmen Castaneda-Sceppa,et al.  Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. , 2007, Circulation.

[31]  Matthew B. Garber,et al.  Annals of Internal Medicine Effectiveness of Manual Physical Therapy and Exercise in Osteoarthritis of the Knee A Randomized, Controlled Trial , 2000 .

[32]  T. Spector,et al.  Osteoarthritis: New Insights. Part 1: The Disease and Its Risk Factors , 2000, Annals of Internal Medicine.

[33]  Sanjay Kalra,et al.  OBJECTIVELY MEASURED LIGHT‐INTENSITY PHYSICAL ACTIVITY IS INDEPENDENTLY ASSOCIATED WITH 2‐H PLASMA GLUCOSE , 2008 .

[34]  M Lequesne,et al.  Atlas of individual radiographic features in osteoarthritis. , 1995, Osteoarthritis and cartilage.

[35]  A. Bauman,et al.  Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. , 2007, Circulation.

[36]  C. Helmick,et al.  Projections of US prevalence of arthritis and associated activity limitations. , 2006, Arthritis and rheumatism.

[37]  M. Heo,et al.  Changes in the Prevalence of US Adults With Arthritis Who Meet Physical Activity Recommendations, 2001–2003 , 2005, Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases.

[38]  M. Hamilton,et al.  Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low‐intensity activity , 2003, The Journal of physiology.

[39]  S. Gabriel,et al.  Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. , 2008, Arthritis and rheumatism.

[40]  J. Lynch,et al.  Comparison of fixed-flexion positioning with fluoroscopic semi-flexed positioning for quantifying radiographic joint-space width in the knee: test-retest reproducibility , 2003, Skeletal Radiology.

[41]  E. Yelin,et al.  Cost of musculoskeletal diseases: impact of work disability and functional decline. , 2003, The Journal of rheumatology. Supplement.

[42]  Karsten Froberg,et al.  Reexamination of validity and reliability of the CSA monitor in walking and running. , 2003, Medicine and science in sports and exercise.