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Original article| Volume 94, ISSUE 4, P711-717, April 2013

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Walking to Meet Physical Activity Guidelines in Knee Osteoarthritis: Is 10,000 Steps Enough?

Published:December 10, 2012DOI:https://doi.org/10.1016/j.apmr.2012.11.038

      Abstract

      Objective

      To study if step goals (eg, walking 10,000 steps a day) approximate meeting the 2008 Physical Activity Guidelines for Americans.

      Design

      Cross-sectional observational cohort.

      Setting

      Community.

      Participants

      People with or at high risk of knee OA (N=1788).

      Interventions

      None.

      Main Outcome Measures

      Objective physical activity data were collected over 7 consecutive days from people with or at high risk of knee OA participating in the Multicenter Osteoarthritis Study. Using activity monitor data, we determined the proportion that (1) walked ≥10,000 steps per day, (2) met the 2008 Physical Activity Guidelines, and (3) achieved both recommendations.

      Results

      Of the subjects studied (mean age ± SD, 67±8y; mean body mass index ± SD, 31±6kg/m2; 60% women), 16.7% of men and 12.6% of women walked ≥10,000 steps per day, while 6% of men and 5% of women met the 2008 Physical Activity Guidelines for Americans. Of those walking ≥10,000 steps per day, 16.7% and 26.7% of men and women, respectively, also met the 2008 Physical Activity Guidelines.

      Conclusions

      Among this sample of older adults with or at high risk of knee OA, walking ≥10,000 steps a day did not translate into meeting public health guidelines. These findings highlight the disparity between the number of steps believed to be needed per day and the recommended time-intensity guidelines to achieve positive health benefits.

      Keywords

      List of abbreviations:

      BMI (body mass index), CI (confidence interval), DHHS (Department of Health and Human Services), MOST (Multicenter Osteoarthritis Study), OA (osteoarthritis), ROC (receiver operating characteristic)
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      References

        • Zhang Y.
        • Jordan J.M.
        Epidemiology of osteoarthritis.
        Clin Geriatr Med. 2010; 26: 355-369
        • Guccione A.A.
        • Felson D.T.
        • Anderson J.J.
        Defining arthritis and measuring functional status in elders: methodological issues in the study of disease and physical disability.
        Am J Public Health. 1990; 80: 945-949
        • Hootman J.M.
        • Helmick C.G.
        Projections of US prevalence of arthritis and associated activity limitations.
        Arthritis Rheum. 2006; 54: 226-229
        • Guccione A.A.
        • Felson D.T.
        • Anderson J.J.
        • et al.
        The effects of specific medical conditions on the functional limitations of elders in the Framingham Study.
        Am J Public Health. 1994; 84: 351-358
        • Nuesch E.
        • Dieppe P.
        • Reichenbach S.
        • Williams S.
        • Iff S.
        • Juni P.
        All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study.
        BMJ. 2011; 342: d1165
        • Yusuf H.R.
        • Croft J.B.
        • Giles W.H.
        • et al.
        Leisure-time physical activity among older adults. United States, 1990.
        Arch Intern Med. 1996; 156: 1321-1326
        • Centers for Disease Control and Prevention (CDC)
        Compliance with physical activity recommendations by walking for exercise–Michigan, 1996 and 1998.
        MMWR Morb Mortal Wkly Rep. 2000; 49: 560-565
        • Hootman J.M.
        • Macera C.A.
        • Ham S.A.
        • Helmick C.G.
        • Sniezek J.E.
        Physical activity levels among the general US adult population and in adults with and without arthritis.
        Arthritis Rheum. 2003; 49: 129-135
        • Ettinger Jr., W.H.
        • Burns R.
        • Messier S.P.
        • et al.
        A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST).
        JAMA. 1997; 277: 25-31
        • Messier S.P.
        • Loeser R.F.
        • Miller G.D.
        • et al.
        Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial.
        Arthritis Rheum. 2004; 50: 1501-1510
        • Bravata D.M.
        • Smith-Spangler C.
        • Sundaram V.
        • et al.
        Using pedometers to increase physical activity and improve health: a systematic review.
        JAMA. 2007; 298: 2296-2304
        • Garber C.E.
        • Blissmer B.
        • Deschenes M.R.
        • et al.
        American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise.
        Med Sci Sports Exerc. 2011; 43: 1334-1359
        • Hellmich N.
        Journey to better fitness starts with 10,000 steps.
        US Today, June 29, 1999 (p 8-9.)
      1. Feury M. Walk off the weight. Women's Day. September 12, 2000: 74-8.

      2. U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans 2010. Available at: http://www.health.gov/PAGuidelines. Accessed December 26, 2012.

      3. NIH Consensus Development Panel on Physical Activity and Cardiovascular Health. Physical activity and cardiovascular health.
        JAMA. 1996; 276: 241-246
      4. Centers for Disease Control and Prevention. How much physical activity do adults need? 2012. Available at: http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html. Accessed August 23, 2012.

        • Nelson M.E.
        • Rejeski W.J.
        • Blair S.N.
        • et al.
        Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association.
        Med Sci Sports Exerc. 2007; 39: 1435-1445
      5. World Health Organization. Global recomendations on physical activity for health. 2012. Available at: http://www.who.int/dietphysicalactivity/factsheet_recommendations/en/. Accessed August 23, 2012.

        • Pal S.
        • Cheng C.
        • Ho S.
        The effect of two different health messages on physical activity levels and health in sedentary overweight, middle-aged women.
        BMC Public Health. 2011; 11: 204
        • Jones D.B.
        • Richeson N.E.
        • Croteau K.A.
        • Farmer B.C.
        Focus groups to explore the perceptions of older adults on a pedometer-based intervention.
        Res Q Exerc Sport. 2009; 80: 710-717
        • Dunlop D.D.
        • Song J.
        • Semanik P.A.
        • et al.
        Objective physical activity measurement in the osteoarthritis initiative: are guidelines being met?.
        Arthritis Rheum. 2011; 63: 3372-3382
        • Felson D.T.
        • Niu J.
        • Guermazi A.
        • et al.
        Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging.
        Arthritis Rheum. 2007; 56: 2986-2992
        • Felson D.T.
        • Anderson J.J.
        • Naimark A.
        • Walker A.M.
        • Meenan R.F.
        Obesity and knee osteoarthritis. The Framingham Study.
        Ann Intern Med. 1988; 109: 18-24
        • Mudge S.
        • Taylor D.
        • Chang O.
        • Wong R.
        Test-retest reliability of the StepWatch Activity Monitor outputs in healthy adults.
        J Phys Act Health. 2010; 7: 671-676
        • Resnick B.
        • Nahm E.S.
        • Orwig D.
        • Zimmerman S.S.
        • Magaziner J.
        Measurement of activity in older adults: reliability and validity of the Step Activity Monitor.
        J Nurs Meas. 2001; 9: 275-290
        • Storti K.L.
        • Pettee K.K.
        • Brach J.S.
        • Talkowski J.B.
        • Richardson C.R.
        • Kriska A.M.
        Gait speed and step-count monitor accuracy in community-dwelling older adults.
        Med Sci Sports Exerc. 2008; 40: 59-64
        • Song J.
        • Semanik P.
        • Sharma L.
        • et al.
        Assessing physical activity in persons with knee osteoarthritis using accelerometers: data from the osteoarthritis initiative.
        Arthritis Care Res (Hoboken). 2010; 62: 1724-1732
        • Troiano R.P.
        • Berrigan D.
        • Dodd K.W.
        • Masse L.C.
        • Tilert T.
        • McDowell M.
        Physical activity in the United States measured by accelerometer.
        Med Sci Sports Exerc. 2008; 40: 181-188
        • King W.C.
        • Li J.
        • Leishear K.
        • Mitchell J.E.
        • Belle S.H.
        Determining activity monitor wear time: an influential decision rule.
        J Phys Act Health. 2011; 8: 566-580
        • Trost S.G.
        • McIver K.L.
        • Pate R.R.
        Conducting accelerometer-based activity assessments in field-based research.
        Med Sci Sports Exerc. 2005; 37: S531-S543
        • Tyo B.M.
        • Fitzhugh E.C.
        • Bassett Jr., D.R.
        • John D.
        • Feito Y.
        • Thompson D.L.
        Effects of body mass index and step rate on pedometer error in a free-living environment.
        Med Sci Sports Exerc. 2011; 43: 350-356
        • Feito Y.
        • Bassett D.R.
        • Thompson D.L.
        • Tyo B.M.
        Effects of body mass index on step count accuracy of physical activity monitors.
        J Phys Act Health. 2012; 9: 594-600
        • Marshall S.J.
        • Levy S.S.
        • Tudor-Locke C.E.
        • et al.
        Translating physical activity recommendations into a pedometer-based step goal: 3000 steps in 30 minutes.
        Am J Prev Med. 2009; 36: 410-415
        • Tudor-Locke C.
        • Brashear M.M.
        • Johnson W.D.
        • Katzmarzyk P.T.
        Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women.
        Int J Behav Nutr Phys Act. 2010; 7: 60
        • Tudor-Locke C.
        • Sisson S.B.
        • Collova T.
        • Lee S.M.
        • Swan P.D.
        Pedometer-determined step count guidelines for classifying walking intensity in a young ostensibly healthy population.
        Can J Appl Physiol. 2005; 6: 666-676
        • Tudor-Locke C.
        • Jones R.
        • Myers A.M.
        • Paterson D.H.
        • Ecclestone N.A.
        Contribution of structured exercise class participation and informal walking for exercise to daily physical activity in community-dwelling older adults.
        Res Q Exerc Sport. 2002; 73: 350-356
        • Welk G.J.
        • Differding J.A.
        • Thompson R.W.
        • Blair S.N.
        • Dziura J.
        • Hart P.
        The utility of the Digi-walker step counter to assess daily physical activity patterns.
        Med Sci Sports Exerc. 2000; 32: S481-S488
        • Wilde B.E.
        • Sidman C.L.
        • Corbin C.B.
        A 10,000-step count as a physical activity target for sedentary women.
        Res Q Exerc Sport. 2001; 72: 411-414
        • World Health Organization
        Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. WHO Technical Report Series 894.
        World Health Organization, Geneva2000
        • White D.K.
        • Zhang Y.
        • Niu J.
        • et al.
        Do worsening knee radiographs mean greater chances of severe functional limitation?.
        Arthritis Care Res (Hoboken). 2010; 62: 1433-1439
        • Katz J.N.
        • Chang L.C.
        • Sangha O.
        • Fossel A.H.
        • Bates D.W.
        Can comorbidity be measured by questionnaire rather than medical record review?.
        Med Care. 1996; 34: 73-84
        • Radloff L.
        The CES-D Scale: a self-report depression scale for research in the general population.
        Appl Psychol Meas. 1977; 1: 385-401
        • Wolfe F.
        • Smythe H.A.
        • Yunus M.B.
        • et al.
        The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee.
        Arthritis Rheum. 1990; 33: 160-172
        • White D.K.
        • Keysor J.J.
        • Neogi T.
        • et al.
        When it hurts, a positive attitude may help: association of positive affect with daily walking in knee osteoarthritis. Results from a multicenter longitudinal cohort study.
        Arthritis Care Res (Hoboken). 2012; 64: 1312-1319
        • Akobeng A.K.
        Understanding diagnostic tests 3: Receiver operating characteristic curves.
        Acta Paediatr. 2007; 96: 644-647
        • Rothman K.
        • Greenland S.
        • Lash T.
        Modern epidemiology.
        3rd ed. Lippincott Williams & Wilkins, Philadelphia2008
        • Tucker J.M.
        • Welk G.J.
        • Beyler N.K.
        Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans.
        Am J Prev Med. 2011; 40: 454-461
        • Fontaine K.R.
        • Heo M.
        Changes in the prevalence of US adults with arthritis who meet physical activity recommendations, 2001-2003.
        J Clin Rheumatol. 2005; 11: 13-16
        • White D.
        • Tudor-Locke C.
        • Felson D.T.
        • et al.
        Do radiographic disease and pain account for why people with or at high risk of knee osteoarthritis do not meet physical activity guidelines?.
        Arthritis Rheum. 2013; 65: 139-147
        • Strazdins L.
        • Broom D.H.
        • Banwell C.
        • McDonald T.
        • Skeat H.
        Time limits? Reflecting and responding to time barriers for healthy, active living in Australia.
        Health Promot Int. 2011; 26: 46-54
        • Serour M.
        • Alqhenaei H.
        • Al-Saqabi S.
        • Mustafa A.R.
        • Ben-Nakhi A.
        Cultural factors and patients' adherence to lifestyle measures.
        Br J Gen Pract. 2007; 57: 291-295
        • Tudor-Locke C.
        • Johnson W.D.
        • Katzmarzyk P.T.
        Accelerometer-determined steps per day in US adults.
        Med Sci Sports Exerc. 2009; 41: 1384-1391
        • Colley R.C.
        • Garriguet D.
        • Janssen I.
        • Craig C.L.
        • Clarke J.
        • Tremblay M.S.
        Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey.
        Health Rep. 2011; 22: 7-14
        • Tudor-Locke C.
        • Bassett Jr., D.R.
        How many steps/day are enough? Preliminary pedometer indices for public health.
        Sports Med. 2004; 34: 1-8
        • Tudor-Locke C.
        • Hatano Y.
        • Pangrazi R.P.
        • Kang M.
        Revisiting “how many steps are enough?”.
        Med Sci Sports Exerc. 2008; 40: S537-S543