Hiral Master1, Louise M Thoma2, Tuhina Neogi3, Dorothy D Dunlop4, Michael LaValley5, Meredith B Christiansen6, Dana Voinier6, Daniel K White7. 1. Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN. 2. Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC. 3. Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, MA. 4. Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL. 5. School of Public Health, Boston University, Boston, MA. 6. Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE. 7. Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE. Electronic address: dkw@udel.edu.
Abstract
OBJECTIVE: To examine the association of the volume and intensity of daily walking at baseline with the risk of knee replacement (KR) over 5 years in adults with advanced structural knee osteoarthritis. DESIGN: Prospective, longitudinal, and multicenter observational study. SETTING: Osteoarthritis Initiative study with follow-up from 2008-2015. PARTICIPANTS: Community-dwelling adults with or at risk of knee osteoarthritis were recruited from 4 sites in the United States (N=516; mean age, 67.7±8.6y; body mass index, 29.3±4.7 kg/m2; 52% female). We included participants with advanced structural disease, without KR and had valid daily walking data (quantified using Actigraph GT1M), at baseline. INTERVENTIONS: Not applicable. MAIN OUTCOMES: KR. Walking volume was measured as steps/day and intensity as minutes/day spent not walking (0 steps/min) and walking at very light (1-49 steps/min), light (50-100 steps/min), or moderate (>100 steps/min) intensities. To examine the relationship of walking volume and intensity with the risk of KR, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for covariates. RESULTS: Of 516 adults with advanced structural disease, 88 received a KR over 5 years (17%). Walking an additional 1000 steps/d was not associated with the risk of KR (adjusted HR=0.95; 95% CI, 0.84-1.04). Statistically, replacing 10 min/d of very light and light walking with 10 min/d of moderate walking reduced the risk of KR incidence by 35% and 37%, respectively (adjusted HR=0.65, 95% CI, 0.45-0.94, for very light and adjusted HR=0.63; 95% CI, 0.40-1.00, for light). CONCLUSIONS: Daily walking volume and intensity did not increase KR risk over 5 years and may be protective in some cases in adults with advanced structural knee osteoarthritis.
OBJECTIVE: To examine the association of the volume and intensity of daily walking at baseline with the risk of knee replacement (KR) over 5 years in adults with advanced structural knee osteoarthritis. DESIGN: Prospective, longitudinal, and multicenter observational study. SETTING: Osteoarthritis Initiative study with follow-up from 2008-2015. PARTICIPANTS: Community-dwelling adults with or at risk of knee osteoarthritis were recruited from 4 sites in the United States (N=516; mean age, 67.7±8.6y; body mass index, 29.3±4.7 kg/m2; 52% female). We included participants with advanced structural disease, without KR and had valid daily walking data (quantified using Actigraph GT1M), at baseline. INTERVENTIONS: Not applicable. MAIN OUTCOMES: KR. Walking volume was measured as steps/day and intensity as minutes/day spent not walking (0 steps/min) and walking at very light (1-49 steps/min), light (50-100 steps/min), or moderate (>100 steps/min) intensities. To examine the relationship of walking volume and intensity with the risk of KR, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for covariates. RESULTS: Of 516 adults with advanced structural disease, 88 received a KR over 5 years (17%). Walking an additional 1000 steps/d was not associated with the risk of KR (adjusted HR=0.95; 95% CI, 0.84-1.04). Statistically, replacing 10 min/d of very light and light walking with 10 min/d of moderate walking reduced the risk of KR incidence by 35% and 37%, respectively (adjusted HR=0.65, 95% CI, 0.45-0.94, for very light and adjusted HR=0.63; 95% CI, 0.40-1.00, for light). CONCLUSIONS: Daily walking volume and intensity did not increase KR risk over 5 years and may be protective in some cases in adults with advanced structural knee osteoarthritis.
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