Impact of Osteoarthritis on Difficulty Walking: A Population‐Based Study

Abstract

Objective. To assess the relationship of hip and knee osteoarthritis (OA) to walking difficulty. Methods. A population cohort ages ≤55 years recruited from 1996 to 1998 (n = 28,451) completed a standardized questionnaire assessing demographics, health conditions, joint symptoms, and functional limitations, including difficulty walking in the past 3 months. Survey data were linked to health administrative databases; self-report and administrative data were used to identify health conditions. Hip/knee OA was defined as self-reported swelling, pain, or stiffness in a hip or knee lasting ≥6 weeks in the past 3 months without an inflammatory arthritis diagnosis. Using multivariable logistic regression, we examined the determinants of walking difficulty and constructed a clinical nomogram. Results. A total of 18,490 cohort participants were eligible (mean age 68 years, 60% women), and 25% reported difficulty walking. Difficulty walking was significantly and independently associated with older age, female sex, body mass index, and several health conditions. Of the conditions examined, the likelihood of walking difficulty was greatest with hip and knee OA and increased with the number of hip/knee joints affected. The predicted probability of difficulty walking for a 60-year-old middle-income, normal-weight woman was 5-10% with no health conditions, 10-20% with diabetes mellitus and cardiovascular (CV) disease, 40% with OA in 2 hips/knees, 60-70% with diabetes mellitus, CV disease, and OA in 2 hips/knees, and 80% with diabetes mellitus, CV disease, and OA in all hips/knees. Conclusion. In a population cohort, symptomatic hip/knee OA was the strongest contributor to walking difficulty. Given the importance of walking to engagement in physical activity for chronic disease management, greater attention to OA is warranted.

Osteoarthritis‐Related Walking Disability and Arterial Stiffness: Results From a Cross‐Sectional Study

“…Regular exercise is a prerequisite for maintenance and improvement of cardiorespiratory capacity , and walking ability is an important prerequisite for engaging in exercise. However, results from a recent population‐based cohort study showed that hip OA or knee OA is a strong contributor to walking difficulty , and only a small‐to‐moderate proportion of patients with hip OA or knee OA meet the guidelines for physical activity . Many patients with OA spend a considerable amount of time being sedentary, leading to more impairment in physical function, reduced walking speed , and poorer cardiometabolic health compared with their peers who had a less sedentary lifestyle.…”

“…Fernandes and Valdes recently reported risk factors shared by both conditions, including age, obesity, chronic inflammation, treatment with nonsteroidal antiinflammatory drugs (NSAIDs), physical inactivity, and walking disability . Patients with hip OA and those with knee OA tend to avoid painful physical activity, resulting in walking disability and physical inactivity , which in turn result in reduced cardiorespiratory fitness. Because cardiorespiratory fitness is an important independent predictor of CVD , OA may be considered to be an indirect cause of CVD .…”

Limitations in Activities of Daily Living in People With Chronic Pain: Identification of Groups Using Clusters Analysis

“…Several studies carried out in older people have shown considerable ADL problems in these subjects, and have explained that single sensory impairments (either visual or auditory) are significantly and independently linked with a high risk for depression and decreased self‐sufficiency in ADLs, which can adversely affect mobility and the ability to perform ADLs . Furthermore, it seems reasonable to think that the physiological deterioration due to age can be increased or accelerated by the presence of pain that, on many occasions, is due to the musculoskeletal pathology that frequently affects this population …”

Effectiveness of Mulligan Joint Mobilizations and Trunk Stabilization Exercises Versus Isometric Knee Strengthening in the Management of Knee Osteoarthritis: Study Protocol for a Randomized Controlled Trial.

“…There is therefore a need to devise a cost effective treatment strategy to limit functional decline, joint pain and stiffness. 1 People with osteoarthritis tend to avoid activity due to severe pain, but exercise has proved to be an effective treatment for this condition, reducing pain and improving physical function by improving the strength of the muscles surrounding the knee joint. Twenty-four sessions of therapeutic exercise appear to provide the most bene cial effects, but these effects have not been tested for walking capacity in a 6minute walk test.…”