Physical activity level and association with behavioral factors in knee osteoarthritis

Gay, Chloé; Guiguet‐Auclair, Candy; Mourgues, Charline; Gerbaud, Laurent; Coudeyre, Emmanuel

doi:10.1016/j.rehab.2018.09.005

Cited by 42 publications

(34 citation statements)

References 28 publications

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“…However, other findings in the OA literature related to pain are conflicting. Some studies have demonstrated that higher pain is associated with lower physical activity in patients with knee OA [37,38] while others have not [39]. Lazaridou et al [14] similarly reported that the association between physical activity levels and pain intensity was moderated by pain catastrophizing.…”

Section: Discussionmentioning

confidence: 99%

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

Uritani

Kasza

Campbell

et al. 2020

BMC Musculoskelet Disord

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Background: The aim of this study was to examine the relationship between psychological characteristics and physical activity levels, measured as the average number of steps per day, in people with knee osteoarthritis (OA). Methods: This study analysed baseline data from a randomized controlled trial (Australian New Zealand Clinical Trials Registry reference: ACTRN12612000308897). A total of 167 adults aged over 50 years, with knee pain rated as four or more on an 11-point numeric rating scale, and knee OA diagnosed using American College of Rheumatology clinical criteria, were recruited from the community (62 men and 105 women, mean age, 62.2 ± 7.5 years). The average number of steps per day over seven consecutive days was measured using an accelerometerbased device. Psychological characteristics evaluated were: depressive symptoms (Depression Anxiety Stress Scale), self-efficacy (Arthritis Self-Efficacy Scale for pain and other symptoms), fear of movement (Brief Fear of Movement Scale for Osteoarthritis), and pain catastrophizing (Pain Catastrophizing Scale). The association between the average number of steps per day and psychological characteristics was analyzed using a multiple linear regression analysis, with the average number of steps per day as the dependent variable, adjusting for each psychological characteristic separately, and age, sex, body mass index, and pain entered as covariates. Results: There was evidence that the amount of physical activity was associated with fear of movement (coefficient [B]: − 117, 95% confidence interval [95%CI]: − 227 to − 8) and with pain catastrophizing (B:-44, 95%CI: − 86 to − 1). The association with self-efficacy was similar (B:117, 95%CI: − 12 to 246). However, the direction of the association with depressive symptoms was less clear (B:-59, 95%CI: − 138 to 19). Conclusions: The results of this study revealed that the relationship was such that lower fear of movement and lower pain catastrophizing may be associated with more steps per day. It may be hypothesized that fear of moving and pain catastrophizing lead to activity avoidance and that strategies to improve these disease-related psychological aspects may be useful in enhancing physical activity participation, although this hypothesis is highly speculative and needs further testing given the cross-sectional design of this study.

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Section: Discussionmentioning

confidence: 99%

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

Uritani

Kasza

Campbell

et al. 2020

BMC Musculoskelet Disord

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“…However, we saw no such trends, and spontaneous changes after the IDI is unlikely. Further, it is likely that patients in this group, who have dealt with being overweight/obese and having knee OA for many years, have had a general low activity level for a long period of their lives , making it less likely that they spontaneously change behavior. Another limitation is the frequency of accelerometer malfunctions (in 21% of participants).…”

Section: Discussionmentioning

confidence: 99%

Association Between Weight Loss and Spontaneous Changes in Physical Inactivity in Overweight/Obese Individuals With Knee Osteoarthritis: An Eight‐Week Prospective Cohort Study

Bartholdy

Christensen

Kristensen

et al. 2020

Arthritis Care & Research

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Objective To describe spontaneous changes in time spent being physically inactive that is measured continuously by accelerometry during an 8‐week weight‐loss intervention in overweight/obese individuals with knee osteoarthritis (OA). Methods This study was designed as an observational cohort study including individuals from an OA outpatient clinic who were concomitantly overweight/obese and had symptomatic knee OA. Participants completed an 8‐week dietary intervention that had been previously shown to induce substantial weight loss. The main outcome was accelerometer‐based measurement of daily physical inactivity for 24 hours during the 8‐week intervention period that was presented as change in the average daily time spent inactive (sitting, reclined, or sleeping) from 1 week prior to intervention to the last week of the intervention. Results A total of 124 participants completed the dietary intervention and had valid accelerometer recordings. The mean weight loss was 12.7 kg (95% confidence interval [95% CI] –13.2, –12.1; P < 0.0001) after 8 weeks, which corresponded to a decrease in body mass index of 4.3 kg/m2 (95% CI –4.5, –4.2; P < 0.0001). Significant improvements in OA symptoms (assessed by the Knee Injury and Osteoarthritis Outcome Score [KOOS]) was found across all subscales; an improvement of 12.8 points (95% CI 10.6, 15.0; P < 0.0001) was observed for pain using the KOOS. No statistically significant change occurred in the average daily time spent inactive from baseline to follow‐up (mean change 8.8 minutes/day [95% CI –12.1, 29.7]; P = 0.41). Conclusion Physical inactivity remains stable despite a clinically significant weight loss and improvements in knee OA symptoms. Change in inactivity does not seem to occur spontaneously, suggesting that focused efforts to reduce inactive behaviors are needed.

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“…This would be supported by the result from the present meta-regression analysis. Patients eligible for TKA are not very physically active due to limitations related to their knee condition 64,65 . Inactive lifestyle leads to decrease in muscle strength and physical ability, especially in older adults 66e68 leaving a large potential for improvement 42 .…”

Section: Dose-responsementioning

confidence: 99%

The relationship between prescribed pre-operative knee-extensor exercise dosage and effect on knee-extensor strength prior to and following total knee arthroplasty: a systematic review and meta-regression analysis of randomized controlled trials

Husted

Juhl

Troelsen

et al. 2020

Osteoarthritis and Cartilage

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Objective: The aim of this systematic review was to evaluate the relationship between prescribed kneeextensor strength exercise dosage in pre-operative exercise intervention and the effect on knee-extensor muscle strength prior to and following TKA. Additional meta-analyses report the effect of pre-habilitation on outcomes prior to and following TKA. Design: A systematic literature search was performed including RCT's evaluating the effect of preoperative exercise prior to and following TKA. Meta-regression analysis was performed to evaluate the dose-response relationship between prescribed exercise dose and the pooled effect, measured as standardized mean difference (SMD). The prescribed exercise dose was quantified using a formula accounting for as many exercise descriptors as possible. Risk of bias in the included trials was assessed using the Cochrane Risk of Bias Tool. Results: Twelve trials with 616 patients were included. Meta-regression analysis showed no relationship between prescribed pre-operative knee-extensor exercise dosage and change in knee-extensor strength neither prior to (slope 0.0005 [95%CI-0.007 to 0.008]) or 3 months following TKA (slope 0.0014 [95%CI-0.006 to 0.009]). Prior to TKA, a moderate effect favoring pre-operative exercise for increase in kneeextensor strength was found (SMD 0.50 [95%CI 0.12 to 0.88]), but not at 3 months following TKA (SMD-0.01 [95%CI-0.45 to 0.43]). Risk of bias was generally assessed as unclear. Conclusion: Meta-regression analysis of existing trials suggests no relationship between the prescribed pre-operative knee-extensor exercise dosage and the change in knee-extensor strength observed prior to and following TKA. Pre-operative exercise including knee-extensor muscle strength exercise increased knee-extensor strength moderately prior to but not 3 months following TKA.

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Physical activity level and association with behavioral factors in knee osteoarthritis

Cited by 42 publications

References 28 publications

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

Association Between Weight Loss and Spontaneous Changes in Physical Inactivity in Overweight/Obese Individuals With Knee Osteoarthritis: An Eight‐Week Prospective Cohort Study

The relationship between prescribed pre-operative knee-extensor exercise dosage and effect on knee-extensor strength prior to and following total knee arthroplasty: a systematic review and meta-regression analysis of randomized controlled trials

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