Daily Walking and the Risk of Knee Replacement Over 5 Years Among Adults With Advanced Knee Osteoarthritis in the United States

Hiral Master; Louise M. Thoma; Tuhina Neogi; Dorothy D. Dunlop; Michael LaValley; Meredith B. Christiansen; Dana Voinier; Daniel K. White

doi:10.1016/j.apmr.2021.05.014

Daily Walking and the Risk of Knee Replacement Over 5 Years Among Adults With Advanced Knee Osteoarthritis in the United States

Hiral Master, Louise M. Thoma, Tuhina Neogi, Dorothy D. Dunlop, Michael LaValley, Meredith B. Christiansen, Dana Voinier, Daniel K. White^*

^*Corresponding author for this work

Medicine, Rheumatology Division

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

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.

Original language	English (US)
Pages (from-to)	1888-1894
Number of pages	7
Journal	Archives of physical medicine and rehabilitation
Volume	102
Issue number	10
DOIs	https://doi.org/10.1016/j.apmr.2021.05.014
State	Published - Oct 2021

Funding

Supported in part by the University Doctoral Fellowship Award from Unidel Foundation (award nos. R21-AR071079-01A1, K12HD055931-0y1, 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. 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.

Keywords

Arthroplasty
Exercise
Pain
Rehabilitation
Replacement, knee
Walking

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation

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10.1016/j.apmr.2021.05.014

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@article{0243ce3265f8422ca45586b09f1d9eaf,

title = "Daily Walking and the Risk of Knee Replacement Over 5 Years Among Adults With Advanced Knee Osteoarthritis in the United States",

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 = "Arthroplasty, Exercise, Pain, Rehabilitation, Replacement, knee, Walking",

author = "Hiral Master and Thoma, {Louise M.} and Tuhina Neogi and Dunlop, {Dorothy D.} and Michael LaValley and Christiansen, {Meredith B.} and Dana Voinier and White, {Daniel K.}",

note = "Publisher Copyright: {\textcopyright} 2021 The American Congress of Rehabilitation Medicine",

year = "2021",

month = oct,

doi = "10.1016/j.apmr.2021.05.014",

language = "English (US)",

volume = "102",

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T1 - Daily Walking and the Risk of Knee Replacement Over 5 Years Among Adults With Advanced Knee Osteoarthritis in the United States

AU - Master, Hiral

AU - Thoma, Louise M.

AU - Neogi, Tuhina

AU - Dunlop, Dorothy D.

AU - LaValley, Michael

AU - Christiansen, Meredith B.

AU - Voinier, Dana

AU - White, Daniel K.

PY - 2021/10

Y1 - 2021/10

N2 - 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.

AB - 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.

KW - Arthroplasty

KW - Exercise

KW - Pain

KW - Rehabilitation

KW - Replacement, knee

KW - Walking

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Daily Walking and the Risk of Knee Replacement Over 5 Years Among Adults With Advanced Knee Osteoarthritis in the United States

Abstract

Funding

Keywords

ASJC Scopus subject areas

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