Does the intensity of daily walking matter for protecting against the development of a slow gait speed in people with or at high risk of knee osteoarthritis? An observational study

Abstract

When possible, walking at a moderate-to-vigorous intensity (>100 steps/min) may be best recommended in order to reduce the risk of developing critical slow gait speed among people with, or at high risk of knee OA.

Assessment of Free-Living Cadence Using ActiGraph Accelerometers Between Individuals With and Without Anterior Cruciate Ligament Reconstruction

“…We sought to determine whether individuals with ACLR displayed patterns of reduced free-living cadence when compared with individuals without a history of knee injury because less time spent in moderate-to vigorous-intensity ambulation is a risk factor for developing habitually slow gait speed, which has been linked to the development and progression of chronic disease. 5 We opted to focus on freeliving cadence because it can be assessed using costeffective and clinically feasible tools, 9 and effective interventions to enhance cadence during free-living activities can be developed using commercially available wearable and mobile technologies. 6 Individuals in the ACLR group spent less time per week walking in a manner that enabled them to accumulate at least 100 steps per minute than did the individuals in the control group despite a lack of between-groups differences in peak 1-minute cadence rates.…”

“…Minute-level cadence, or the number of steps an individual takes during a given minute during the day, has been implicated in the progression of slow gait speed among middle-aged individuals at high risk for knee OA and individuals with diagnosed knee OA later in the lifespan when measured under free-living conditions. 5 The advantage of evaluating cadence as opposed to more traditional temporal gait variables, such as gait speed, that are assessed in a controlled environment (ie, laboratory or clinic setting) is that it can be measured using commercially available or research-grade wearable accelerometers over weeks or months. 6 Such long-term monitoring allows for a more accurate depiction of a patient's habitual gait pattern during activities of daily living (ADLs) than in a clinic or laboratory setting.…”

“…[9][10][11] This is important because slower average gait speed and cadence have been identified as risk factors for functional limitation, chronic disease morbidity, and premature mortality among older adults when assessed in the clinical environment. 5,12 Researchers 5 have hypothesized that reduced gait speed and physical activity engagement and, therefore, reduced cadence may result from biomechanical compensations adopted by patients to avoid pain and maximize functional capacity during ADLs despite underlying articular cartilage degeneration. Specifically, reductions in average daily step count 13 and minutes per week in a moderate-to vigorous-intensity cadence (!100 steps per minute) have been identified among individuals with and at elevated risk for knee-joint OA.…”

“…Specifically, reductions in average daily step count 13 and minutes per week in a moderate-to vigorous-intensity cadence (!100 steps per minute) have been identified among individuals with and at elevated risk for knee-joint OA. 5 However, investigators 14 have also hypothesized that walking at slower speeds may reduce the magnitude and rate of knee-joint loading that occurs during ambulation, resulting in alterations in articular cartilage structure and metabolism in individuals with a history of ACLR. Although cadence is not a direct indicator of gait speed, 15 it is clear that an individual's cadence and physical activity intensity and volume, which are associated with knee articular cartilage health, 14 contribute to habitual gait speed.…”

Walk At Least 10 Minutes a Day for Adults With Knee Osteoarthritis: Recommendation for Minimal Activity During the COVID-19 Pandemic

“…The current PA guidelines recommend at least moderate inten- sity exercise to increase general health benefits. OA-specific benefits, such as substantial reductions in risk of developing functional limitation, can be found at moderate intensities as well 9 . By walking at a brisk pace of at least 100 steps per minute, roughly equivalent to exercising at a moderate to vigorous intensity, it is possible to achieve these benefits 10 .…”