Do radiographic disease and pain account for why people with or at high risk of knee osteoarthritis do not meet physical activity guidelines?

OBJECTIVE Knee osteoarthritis (OA) and pain are assumed to be barriers to meeting physical activity guidelines, but this has not been formally evaluated. The purpose of this study was to determine the proportions of people with and those without knee OA and knee pain who meet recommended physical activity levels through walking. METHODS We performed a cross-sectional analysis of community-dwelling adults from the Multicenter Osteoarthritis Study who had or who were at high risk of knee OA. Participants wore a StepWatch activity monitor to record steps per day for 7 days. The proportion of participants who met the recommended physical activity levels was defined as those accumulating≥150 minutes per week at ≥100 steps per minute in bouts lasting ≥10 minutes. These proportions were also determined for those with and those without knee OA, as classified by radiography and by severity of knee pain. RESULTS Of the 1,788 study participants (mean±SD age 67.2±7.7 years, mean±SD body mass index 30.7±6.0 kg/m2, 60% women), lower overall percentages of participants with radiographic knee OA and knee pain met recommended physical activity levels. However, these differences were not statistically significant between those with and those without knee OA; 7.3% and 10.1% of men (P=0.34) and 6.3% and 7.8% of women (P=0.51), respectively, met recommended physical activity levels. Similarly, for those with moderate/severe knee pain and those with no knee pain, 12.9% and 10.9% of men (P=0.74) and 6.7% and 11.0% of women (P=0.40), respectively, met recommended physical activity levels. CONCLUSION Disease and pain have little impact on achieving recommended physical activity levels among people with or at high risk of knee OA.

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

[2]  O. Chang,et al.  Test-retest reliability of the StepWatch Activity Monitor outputs in healthy adults. , 2010, Journal of physical activity & health.

[3]  L. Radloff The CES-D Scale , 1977 .

[4]  D. Fields,et al.  Effects of 2 brief interventions on women's understanding of moderate-intensity physical activity. , 2008, Journal of physical activity & health.

[5]  Richard W. Bohannon,et al.  Normal walking speed: a descriptive meta-analysis. , 2011, Physiotherapy.

[6]  C Kent Kwoh,et al.  Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met? , 2011, Arthritis and rheumatism.

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

[8]  P. Tugwell,et al.  The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. , 1990, Arthritis and rheumatism.

[9]  Catrine Tudor-Locke,et al.  Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women , 2010, The international journal of behavioral nutrition and physical activity.

[10]  J. Ware SF-36 health survey: Manual and interpretation guide , 2003 .

[11]  T. Andriacchi,et al.  Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. , 2005, Arthritis and rheumatism.

[12]  B. Resnick,et al.  Measurement of Activity in Older Adults: Reliability and Validity of the Step Activity Monitor , 2001, Journal of Nursing Measurement.

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

[14]  Yuqing Zhang,et al.  Epidemiology of osteoarthritis. , 2013, Rheumatic diseases clinics of North America.

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

[16]  M. Sevick,et al.  Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. , 2004, Arthritis and rheumatism.

[17]  S. Reichenbach,et al.  All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study , 2011, BMJ : British Medical Journal.

[18]  B. Ainsworth,et al.  Translating physical activity recommendations into a pedometer-based step goal: 3000 steps in 30 minutes. , 2009, American journal of preventive medicine.

[19]  D. Felson,et al.  Obesity and knee osteoarthritis. The Framingham Study. , 1988, Annals of internal medicine.

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

[21]  Karin Mack,et al.  Walking trends among U.S. adults: the Behavioral Risk Factor Surveillance System, 1987-2000. , 2003, American journal of preventive medicine.

[22]  D W Bates,et al.  Can comorbidity be measured by questionnaire rather than medical record review? , 1996, Medical care.

[23]  J. Tucker,et al.  Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans. , 2011, American journal of preventive medicine.

[24]  Cathy Banwell,et al.  Time limits? Reflecting and responding to time barriers for healthy, active living in Australia. , 2011, Health promotion international.

[25]  Yi-Chung Pai,et al.  Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors. , 2003, Arthritis and rheumatism.

[26]  G. R. Jones,et al.  Contribution of Structured Exercise Class Participation and Informal Walking for Exercise to Daily Physical Activity in Community-Dwelling Older Adults , 2002, Research quarterly for exercise and sport.

[27]  D. Bassett,et al.  Comparison of two waist-mounted and two ankle-mounted electronic pedometers , 2005, European Journal of Applied Physiology.

[28]  J J Anderson,et al.  Defining radiographic osteoarthritis for the whole knee. , 1997, Osteoarthritis and cartilage.

[29]  R. J. Shephard,et al.  Increasing Our Understanding of Reactivity to Pedometers in Adults , 2010 .

[30]  I-Min Lee,et al.  American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. , 2011, Medicine and science in sports and exercise.

[31]  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.

[32]  T. Andriacchi,et al.  Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity: reduced walking speed. , 2004, Arthritis and rheumatism.

[33]  C B Corbin,et al.  A 10,000-Step Count as a Physical Activity Target for Sedentary Women , 2001, Research quarterly for exercise and sport.

[34]  Claude Bouchard,et al.  Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. , 1998, WMJ : official publication of the State Medical Society of Wisconsin.

[35]  P. Wolf,et al.  The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. , 1994, American journal of public health.

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

[37]  M. Hochberg,et al.  Knee pain and knee osteoarthritis severity in self-reported task specific disability: the Johnston County Osteoarthritis Project. , 1997, The Journal of rheumatology.

[38]  M. Nevitt,et al.  The independent effect of pain in one versus two knees on the presence of low physical function in a multicenter knee osteoarthritis study , 2010, Arthritis care & research.

[39]  C. Tudor-Locke,et al.  Pedometer-determined step count guidelines for classifying walking intensity in a young ostensibly healthy population. , 2005, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[40]  Ali Guermazi,et al.  Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging. , 2007, Arthritis and rheumatism.

[41]  S. Blair,et al.  The utility of the Digi-walker step counter to assess daily physical activity patterns. , 2000, Medicine and science in sports and exercise.

[42]  Maleka Serour,et al.  Cultural factors and patients' adherence to lifestyle measures. , 2007, The British journal of general practice : the journal of the Royal College of General Practitioners.

[43]  S. Belle,et al.  Determining activity monitor wear time: an influential decision rule. , 2011, Journal of physical activity & health.

[44]  C. Caspersen,et al.  Leisure-time physical activity among older adults. United States, 1990. , 1996, Archives of internal medicine.

[45]  D. Felson,et al.  Defining arthritis and measuring functional status in elders: methodological issues in the study of disease and physical disability. , 1990, American journal of public health.

[46]  Compliance with physical activity recommendations by walking for exercise--Michigan, 1996 and 1998. , 2000, MMWR. Morbidity and mortality weekly report.

[47]  J. Kellgren,et al.  Radiological Assessment of Osteo-Arthrosis , 1957, Annals of the rheumatic diseases.