HIGHLIGHTS
- •Walking volume and intensity did not expedite knee replacement risk over 5 years.
- •More steps/day was not associated with risk of knee replacement over 5 years.
- •Walking at a moderate intensity was related to a small decrease in knee replacement risk.
Abstract
Objective
To examine the association of the volume and intensity of daily walking at baseline
with the risk of knee replacement (KR) over 5 years in adults with advanced structural
knee osteoarthritis.
Design
Prospective, longitudinal, and multicenter observational study.
Setting
Osteoarthritis Initiative study with follow-up from 2008-2015.
Participants
Community-dwelling adults with or at risk of knee osteoarthritis were recruited from
4 sites in the United States (N=516; mean age, 67.7±8.6y; body mass index, 29.3±4.7
kg/m2; 52% female). We included participants with advanced structural disease, without
KR and had valid daily walking data (quantified using Actigraph GT1M), at baseline.
Interventions
Not applicable.
Main outcomes
KR. Walking volume was measured as steps/day and intensity as minutes/day spent not
walking (0 steps/min) and walking at very light (1-49 steps/min), light (50-100 steps/min),
or moderate (>100 steps/min) intensities. To examine the relationship of walking volume
and intensity with the risk of KR, we calculated hazard ratios (HRs) and 95% confidence
intervals (CIs) adjusting for covariates.
Results
Of 516 adults with advanced structural disease, 88 received a KR over 5 years (17%).
Walking an additional 1000 steps/d was not associated with the risk of KR (adjusted
HR=0.95; 95% CI, 0.84-1.04). Statistically, replacing 10 min/d of very light and light
walking with 10 min/d of moderate walking reduced the risk of KR incidence by 35%
and 37%, respectively (adjusted HR=0.65, 95% CI, 0.45-0.94, for very light and adjusted
HR=0.63; 95% CI, 0.40-1.00, for light).
Conclusions
Daily walking volume and intensity did not increase KR risk over 5 years and may be
protective in some cases in adults with advanced structural knee osteoarthritis.
Keywords
List of abbreviations:
CI (confidence interval), HR (hazard ratio), KL (Kellgren-Lawrence), KR (knee replacement), OA (osteoarthritis), OAI (Osteoarthritis Initiative)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: June 24, 2021
Accepted:
May 25,
2021
Received in revised form:
May 14,
2021
Received:
January 10,
2021
Footnotes
Presented as a poster to the American College of Rheumatology/Association of Rheumatology Health Professionals, October 20–24, 2018, Chicago, IL, and as a poster to the Osteoarthritis Research Society International World Congress, April 26–29, 2018, Liverpool, UK.
Supported in part by the University Doctoral Fellowship Award from Unidel Foundation (award nos. R21-AR071079-01A1, K12HD055931-01, K23AR070913, T32-HD007490, F32AR073090, K24-AR070892, U54 GM104941). We have used publicly available data from the Osteoarthritis Initiative (OAI). The OAI is a public-private partnership composed of 5 contracts (nos. N01-AR-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health (NIH), a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the NIH. This article was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the NIH, or the private funding partners.
Disclosures: None.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
