Longitudinal Effects of Physical Inactivity and Obesity on Gait Speed in Older Adults with Frequent Knee Pain: Data from the Osteoarthritis Initiative

Bindawas, Saad M.; Vennu, Vishal

doi:10.3390/ijerph120201849

Cited by 17 publications

(14 citation statements)

References 47 publications

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“…A directed acyclic graph approach 27 was used to determine which variables would be appropriate to use to adjust for the effects of true aerobic capacity and aid in isolating the distorting effect of motor function on the aerobic capacity measures. Based on the literature, we identified the following potential common causes of both motor dysfunction (lower CGS) and lower aerobic capacity measurement: greater stroke severity, 20,28-30 increased age, 3,31 female sex, 3,31 higher BMI, 3,32,33 depression 34,35 and lower physical activity history. 1,3,20 Hypothesized causal relationships were graphed with unidirectional arrows (Figure 2).…”

Section: Methodsmentioning

confidence: 99%

Ventilatory threshold may be a more specific measure of aerobic capacity than peak oxygen consumption rate in persons with stroke

Boyne

Reisman

Michael

et al. 2016

Topics in Stroke Rehabilitation

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Background After stroke, aerobic deconditioning can have a profound impact on daily activities. This is usually measured by the peak oxygen consumption rate achieved during exercise testing (VO2-peak). However, VO2-peak may be distorted by motor function. The oxygen uptake efficiency slope (OUES) and VO2 at the ventilatory threshold (VO2-VT) could more specifically assess aerobic capacity after stroke, but this has not been tested. Objectives To assess the differential influence of motor function on three measures of aerobic capacity (VO2-peak, OUES and VO2-VT) and to evaluate the inter-rater reliability of VO2-VT determination post-stroke. Methods Among 59 persons with chronic stroke, cross-sectional correlations with motor function (comfortable gait speed [CGS] and lower extremity Fugl-Meyer [LEFM]) were compared between the different aerobic capacity measures, after adjustment for covariates, in order to isolate any distorting effect of motor function. Reliability of VO2-VT determination between 3 raters was assessed with intra-class correlation (ICC). Results CGS was moderately correlated with VO2-peak (r=0.52, p<0.0001) and weakly correlated with OUES (r=0.41, p=0.002) and VO2-VT (r=0.37, p=0.01). LEFM was weakly correlated with VO2-peak (r=0.26, p=0.055) and very weakly correlated with OUES (r=0.19, p=0.17) and VO2-VT (r=0.14, p=0.31). Compared to VO2-peak, VO2-VT was significantly less correlated with CGS (r difference = -0.16, p=0.02). Inter-rater reliability of VO2-VT determination was high (ICC: 0.93, 95%CI: 0.89 to 0.96). Conclusions Motor dysfunction appears to artificially lower measured aerobic capacity. VO2-VT seemed to be less distorted than VO2-peak and had good inter-rater reliability, so it may provide more specific assessment of aerobic capacity post-stroke.

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Section: Methodsmentioning

confidence: 99%

Ventilatory threshold may be a more specific measure of aerobic capacity than peak oxygen consumption rate in persons with stroke

Boyne

Reisman

Michael

et al. 2016

Topics in Stroke Rehabilitation

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“…Knee osteoarthritis (OA) is a chronic disease that manifests as pain, stiffness, swelling and muscle weakness [ 1 , 2 ], causes functional impairment due to lower limb muscle weakness, and is one of the most common diseases in the older persons [ 3 – 7 ]. A previous study reported that subjects with knee pain had a significantly higher incidence of quadriceps weakness after a 30-month period than subjects without pain and that patients with knee OA had a 76% reduction in eccentric quadriceps strength than healthy subjects [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The effects of pain on quadriceps strength, joint proprioception and dynamic balance among women aged 65 to 75 years with knee osteoarthritis

et al. 2018

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BackgroundPatients with knee osteoarthritis (OA) were reported to have quadriceps weakness, and impaired proprioception, both related to pain and swelling. It is unclear whether pain alone a causal factor to above findings over the knee joint. The purpose of this study was to assess the effects of knee pain alone on the quadriceps strength, proprioception and dynamic balance in subjects with bilateral knee OA without joint swelling.MethodsFourty females with mean age of 68.3 years were involved in this cross-sectional study. The inclusion criteria were bilateral knee OA without joint swelling, with a visual analogue pain scale difference (> 1) between each knee. Patients all underwent assessment of the isokinetic strength of knee muscles, knee proprioceptive acuity, and dynamic balance.ResultsPatients’ more painful knee had weaker isokinetic quadriceps strength than less painful knee at both 60 °/s and 180 °/s (p = 0.01, p = 0.01, respectively). There were no differences in proprioceptive acuity between both knees in all three knee positions. Meanwhile, there was a significant difference in the dynamic balance index measurement between both knees (more painful versus less painful: 3.88 ± 1.15 vs. 3.30 ± 1.00, p = 0.01). Quadriceps strength was associated with dynamic balance stability (60 °/s, r = − 0.578, p < 0.01; 180 °/s, r = − 0.439, p < 0.01).ConclusionsFor patients with knee OA, the more painful knee was associated with weaker quadriceps and poor balance ability. To improve lower limb function and balance stability of the older persons having knee OA, physicians should take the optimal pain management strategy.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0932-y) contains supplementary material, which is available to authorized users.

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“…Our results are similar to those of previous studies that have demonstrated independent associations between KP, obesity, and GS. 33 – 35 White et al conducted a multicenter OA cohort study and found that obesity has an important association with slow GS independent of KP. 33 In a cross-sectional study, Vincent et al found an association between KP, obesity, and fear of movement.…”

Section: Discussionmentioning

confidence: 99%

Relationship between frequent knee pain, obesity, and gait speed in older adults: data from the Osteoarthritis Initiative

Bindawas¹

2016

CIA

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Background: Knee pain (KP) causes gait difficulties in older adults and is associated with slow gait speed (GS). Obesity has negative effects on health. GS is an important indicator of health, well-being, and mean life span in older adults and is a strong predictor of future disability and mortality. The relationship between frequent KP, obesity, and GS in older adults remains unclear. Therefore, the present study aimed at examining the relationship between baseline frequent KP and obesity status on GS over time. We hypothesized that frequent KP, obesity, or both would be associated with decreased GS over time. Methods:The data from the Osteoarthritis Initiative were used for this 6-year longitudinal cohort study. We studied 3,118 adults aged between 45 years and 79 years. We grouped the participants into the following four categories according to KP frequency and obesity status at baseline: 1) no KP and nonobese, 2) frequent KP and nonobese, 3) no KP and obese, and 4) frequent KP and obese. GS measurements were based on a 20 m walking test timed using a stopwatch; testing was performed at baseline and over a 6-year follow-up period. Walk pace (m/sec) was calculated as the average pace over two trials conducted at clinic visits. General linear mixed models were used to examine the relationships between frequent KP, obesity, and GS. Results: After adjusting for all covariates, at baseline, all the nonobese group with frequent KP (β=−0.06, 95% confidence interval [CI]: −0.07 to −0.04), the obese group with no KP (β=−0.07, 95% CI: −0.1 to −0.04), and the obese group with frequent KP (β=−0.08, 95% CI: −0.1 to −0.05) exhibited decreased GS compared with the nonobese and no KP group. However, the associations between frequent KP, obesity, and GS over time were not statistically significant. Conclusion: Frequent KP alone, obesity alone, and the combination of frequent KP and obesity were all associated with decreased GS in older adults. These associations did not change in any of the groups longitudinally; as such, the slopes corresponding to the data remained unchanged.

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Longitudinal Effects of Physical Inactivity and Obesity on Gait Speed in Older Adults with Frequent Knee Pain: Data from the Osteoarthritis Initiative

Cited by 17 publications

References 47 publications

Ventilatory threshold may be a more specific measure of aerobic capacity than peak oxygen consumption rate in persons with stroke

Ventilatory threshold may be a more specific measure of aerobic capacity than peak oxygen consumption rate in persons with stroke

The effects of pain on quadriceps strength, joint proprioception and dynamic balance among women aged 65 to 75 years with knee osteoarthritis

Relationship between frequent knee pain, obesity, and gait speed in older adults: data from the Osteoarthritis Initiative

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