Abstract
Introduction: Physical activity guidelines recommend minimum thresholds. This study sought to identify evidence-based thresholds to maintain disability-free status over 4years among adults with lower extremity joint symptoms. Methods: Prospective multisite Osteoarthritis Initiative accelerometer monitoring cohort data from September 2008 through December 2014 were analyzed. Adults (n=1,564) aged ≥49years at elevated disability risk because of lower extremity joint symptoms were analyzed for biennial assessments of disability-free status from gait speed ≥1meter/second (mobility disability–free) and self-report of no limitations in activities of daily living (activities of daily living disability–free). Classification tree analyses conducted in 2017–2018 identified optimal thresholds across candidate activity intensities (sedentary, light, moderate–vigorous, total light and moderate–vigorous activity, and moderate–vigorous accrued in bouts lasting ≥10 minutes). Results: Minimal thresholds of 56 and 55 moderate–vigorous minutes/week best predicted disability-free status over 4years from mobility and activities of daily living disabilities, respectively, across the candidate measures. Thresholds were consistent across sex, BMI, age, and knee osteoarthritis presence. Mobility disability onset was one eighth as frequent (3% vs 24%, RR=0.14, 95% CI=0.09, 0.20) and activities of daily living disability onset was almost half (12% vs 23%, RR=0.55, 95% CI=0.44, 0.70) among people above versus below the minimum threshold. Conclusions: Attaining an evidence-based threshold of approximately 1-hour moderate–vigorous activity/week significantly increased the likelihood of maintaining disability-free status over 4years. This minimum threshold tied to maintaining independent living abilities has value as an intermediate goal to motivate adults to take action towards the many health benefits of a physically active lifestyle.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 664-672 |
| Number of pages | 9 |
| Journal | American Journal of Preventive Medicine |
| Volume | 56 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2019 |
Funding
Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer, Inc. Private sector funding for the Osteoarthritis Initiative is managed by the Foundation for the NIH. The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of NIH, the private funding partners, or the Centers for Disease Control and Prevention. C. Kent Kwoh reported receiving consulting fees from EMD Serono, Astrellas, Thusane, Express Scripts, Regulus, GSK, Regeneron, and grant funding from Pfizer and AbbVie. No other financial disclosures were reported by the authors of this paper. Research reported in this publication was supported in part by the National Institute of Arthritis and Musculoskeletal Diseases under award numbers R01-AR054155, P30-AR072579, and P60-AR48098; the National Center for Advancing Translational Sciences grant UL1-TR001422; and the Falk Medical Trust. The publically released Osteoarthritis Initiative data were funded through a public–private partnership comprising five contracts (N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262) awarded by NIH, a branch of HHS.
ASJC Scopus subject areas
- Epidemiology
- Public Health, Environmental and Occupational Health