Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Characteristics of Persons with or at High Risk of Knee OA Achieving Recommended Physical Activity Levels: The MOST Study.

White1,  Daniel K., Neogi2,  Tuhina, Niu2,  Jingbo, Nevitt3,  Michael, Lewis4,  C. Elizabeth, Torner5,  James, Gross2,  Doug

Boston University, Boston, MA
Boston University
University California San Francisco
University of Alabama
University of Iowa

The CDC recommends physical activity for multiple health benefits with walking being the most common means of obtaining physical activity. However, as few as 24% for persons with self reported arthritis meet these guidelines. Among persons with radiographic knee osteoarthritis (ROA), it is not known how many satisfy these guidelines, nor which factors are associated with meeting them. Hence, we examined the characteristics of persons with or at high risk of ROA that meet activity guidelines as measured by an accelerometer-enabled monitor.

The Multicenter Osteoarthritis Study (MOST) is a NIH funded longitudinal study of people who have or are at high risk for knee OA. Subjects at the 60 month visit wore an accelerometer-enabled monitor to record walking activity over 7 days. Using a disablement model framework, we evaluated pathology, impairment, functional limitation, and psychosocial characteristics associated with meeting CDC guidelines. Specifically, we examined ROA and total knee replacement (TKR) (pathology), knee pain (impairment), self reported difficulty walking and walking at a pedestrian speed (>1.2 m/s) in the clinic (functional limitation), and depressive symptoms (psychosocial). We defined meeting CDC guidelines as walking at least 80 steps per minute for 150 minutes over 7 days. We compared disablement characteristics among persons meeting and not meeting activity guidelines using prevalence ratios adjusted for age, sex, BMI, race, number of comorbidities, and presence of widespread pain.

Of 806 subjects (Age 62 ± 8 yrs, BMI 31 ± 6 kg/m2, female 69%), 174 (22%) met CDC guidelines for physical activity. These persons were more often male with a lower mean age and BMI, and did not have widespread pain. In adjusted models pathology was not associated with meeting CDC guidelines, however persons with bilateral knee pain, self reported difficulty walking, and those who could not walk at a pedestrian speed were 40% to 80% less likely to meet CDC guidelines than their counterparts (see table).

Pathology-related characteristics (ROA and TKR) were not associated with meeting CDC guidelines, whereas pain and functional limitation characteristics were associated. These findings may be encouraging to providers given that these latter factors are potentially modifiable.

  % meeting CDC Guidelines (number meeting guidelines/all subjects)
Age50–59 years28 (86/303)
 60–69 years19 (62/330)
 70–79 years15 (26/173)
SexMale25 (63/251)
 Female20 (111/555)
BMI<3031 (40/129)
 30–3419 (46/245)
 >3510 (16/157)
ComorbiditiesNone25 (140/550)
 >=113 (34/252)
Widespread painAbsent25 (118/478)
 Present17 (56/324)
  % meeting CDC guidelinesAdjusted Prevalence Ratio*95% CI
ROANone28 (90/321)1.0Ref
 Unilateral24 (41/168)0.90.6, 1.4
 Bilateral17 (32/193)0.80.5, 1.3
TKRNone24 (164/699)1.0Ref
 Present9 (10/107)0.60.3, 1.3
Knee painNone31 (94/298)1.0Ref
 Mild unilateral25 (39/157)0.90.6, 1.4
 Mild bilateral13 (4/30)0.50.3, 0.8
 Mod/Sev unilateral16 (31/196)0.40.1, 1.7
 Mod/Sev bilateral5 (6/122)0.20.1, 0.6
Depressive symptomsCES_D <1622 (160/715)1.0Ref
 CES_D>=1616 (14/87)0.80.4, 1.5
Difficulty walkingNo29 (135/467)1.0Ref
 Yes5 (39/336)0.60.4, 0.9
Walking speed>=1.2 m/s33 (127/389)1.0Ref
 1.2 m/s11 (45/394)0.40.1, 1.0
*Adjusted few age, sex BMI, race, the number of comorbities, and widespread pain.

To cite this abstract, please use the following information:
White, Daniel K., Neogi, Tuhina, Niu, Jingbo, Nevitt, Michael, Lewis, C. Elizabeth, Torner, James, et al; Characteristics of Persons with or at High Risk of Knee OA Achieving Recommended Physical Activity Levels: The MOST Study. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :693
DOI: 10.1002/art.28461

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