Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met?

Abstract

Objective Osteoarthritis (OA) clinical practice guidelines identify a substantial therapeutic role for physical activity but objective information about the physical activity of this population is lacking. We objectively measured physical activity levels of adults with knee OA and report the prevalence of meeting public health physical activity guidelines. Methods Cross-sectional accelerometer data from 1111 adults with radiographic knee OA aged 49 to 84 years participating in Osteoarthritis Initiative accelerometer monitoring ancillary study were assessed for meeting the aerobic component of the 2008 Physical Activity Guidelines for Americans (≥150 minutes/week in episodes≥10 minutes). Quantile regression was used to test median gender differences in physical activity levels. Results Aerobic physical activity guidelines were met by 12.9% of men and 7.7% of women with knee OA. A substantial 40.1% of men and 56.5% of women were inactive, doing no moderate-to-vigorous (MV) activity over 7 days that lasted 10 minutes or more. Although men engaged in significantly more MV intensity activity (20.7 vs. 12.3 average daily minutes) they also spent more time in no or very light intensity activity (608.2 vs. 585.8 average daily minutes) than women. Conclusion Despite substantial health benefits from physical activity, adults with knee OA were particularly inactive based on objective accelerometer monitoring. The percentages of men and women who met public health physical activity guidelines were substantially less than previous reports based on self-reported activity in arthritis populations. These findings support intensified public health efforts to increase physical activity levels among persons with knee OA.

Painful knee but not hand osteoarthritis is an independent predictor of mortality over 23 years follow-up of a population-based cohort of middle-aged women

“…The most biologically plausible mechanism for the causal association is that the knee pain results in sedentary behaviour, poor cardiovascular fitness and early mortality. This is supported by some observational studies19 33 37 and by the fact that only 7.7% women with KOA meet recommended PA guidelines 38. However, an alternative pathway might be presented where painful KOA is an early sign of metabolic dysregulation, leading to CVD problems and premature death.…”

Daily Walking and the Risk of Incident Functional Limitation in Knee Osteoarthritis: An Observational Study

“…First, we used a longitudinal study design to investigate the association of steps/day with the development of functional limitation two years later, which is an advance over previous cross-sectional studies. (56, 57) Second, our study provides preliminary pedometer-equivalent step thresholds associated with the development of functional limitation in people with or at risk of knee OA; a paucity of studies currently exist for what number of steps/day to recommend for this patient population.…”

Sedentary behavior and blood pressure control among osteoarthritis initiative participants

“…Sedentary behavior is common among persons with knee OA, who comprised about half of OAI participants and were highly physically inactive. 9 The OAI is a multi-center, longitudinal, observational study of 4796 men and women aged 45 – 79 years at the 2004–2006 enrollment. Adults eligible for the OAI were either required to have symptomatic OA in at least one knee (a definite tibiofemoral osteophyte [osteophyte grade≥ 1 10 ] and pain, aching, or stiffness on most days for at least one month during the past 12 months) or were required to have at least one from a set of established knee OA risk factors.…”

“…The study sample was drawn from the 2127 participants enrolled in an OAI accelerometer monitoring substudy 9 at the OAI 48 month follow visit (2008–2010), from which data were obtained for the present analysis. We included OAI participants who had valid and reliable measures of physical activity (at least 10 hours per day for four or more days, n = 1927).…”