Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Is Knee Pain Relevant for Meeting Physical Activity Guidelines Among People with Knee Osteoarthritis Who Can Walk Already Walk At a Moderate Intensity? the Multicenter Osteoarthritis Study.
White1, Daniel K., Felson1, David T., Zhang1, Yuqing, Gross2, K. Douglas, Niu1, Jingbo, Nevitt3, Michael C., Lewis4, C.E.
Boston University School of Medicine, Boston, MA
MGH Institute of Health Professions, Boston, MA
University of California-San Francisco, San Francisco, CA
University of Alabama, Birmingham City, AL
University of Iowa, Iowa City, Iowa City, IA
Boston University, Boston, MA
Knee pain precludes the ability to walk at a moderate intensity in knee osteoarthritis (OA), which is necessary to meet the Department of Health and Human Services (DHHS) Physical Activity Guidelines. However, it is not known if knee pain is still relevant for meeting Physical Activity Guidelines among those who can already walk at a moderate intensity. Furthermore, it is not known if other modifiable factors, such as strength, walking speed, BMI, or depressive symptoms are relevant as well. Thus, we evaluated the association of knee pain along with other modifiable factors with meeting Physical Activity Guidelines among people with or at high risk of knee OA who could already walk at a moderate intensity.
MOST is an NIH funded study of people who have or are at high risk for knee OA. We selected subjects who were able to walk at a moderate intensity, defined as walking at a step frequency of at least 100 steps per minute during a 20-meter walk. Subjects wore an accelerometer-enabled pedometer (Stepwatch) to record steps taken over 7 days. Using Stepwatch data, we defined meeting Physical Activity Guidelines as walking 150 minutes at a moderate intensity (step frequency of at least 100 steps per minute) in at least 10 continuous minute bouts. We defined knee pain as pain on average in the last 30 days using a 0100 visual analogue scale. We examined the association of knee pain along with isokinetic knee extensor strength, walking at a community speed (>= 1.22 m/s), BMI, and depressive symptoms with meeting Physical Activity Guidelines adjusted for potential confounders using logistic regression.
Of the 1380 subjects who had 7 days of monitoring (Age 67 ± 8 yrs, BMI 31 ± 6 kg/m2, female 60%) 91% (1257/1380) were able to walk at a moderate intensity. Among these subjects, 6.4% (81/1257) met Physical Activity Guidelines. Greater knee pain severity was not associated with meeting Physical Activity Guidelines (OR = 1.0, 95% CI [0.8, 1.1]). In contrast, subjects with a BMI of 25 or less had 6.8 times the odds of meeting guidelines compared with those with a BMI 35 or greater (OR = 6.8 95%CI [1.5, 30.8]). Subjects walking at least a community speed (1.22 m/s) had 2.8 times the odds of meeting guidelines compared with those not walking a community speed (2.8 [1.3, 5.8]). Lastly, those in the highest strength tertile were 2.9 times as likely to meet guidelines compared with those in the lowest strength tertile (2.9 [1.1, 7.6]). Depressive symptoms were not associated with meeting guidelines.
We found BMI, walking speed, and knee strength but not knee pain or depressive symptoms to be associated with meeting guidelines among people who have the ability to walk at a moderate intensity. Targeting strength, walking speed, and BMI may be more promising than treating pain to increase physical activity among people who already have the ability to walk at a moderate intensity assessed in the clinic.
To cite this abstract, please use the following information:
White, Daniel K., Felson, David T., Zhang, Yuqing, Gross, K. Douglas, Niu, Jingbo, Nevitt, Michael C., et al; Is Knee Pain Relevant for Meeting Physical Activity Guidelines Among People with Knee Osteoarthritis Who Can Walk Already Walk At a Moderate Intensity? the Multicenter Osteoarthritis Study. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1724