|Posted by andrew on November 4, 2014 at 1:10 AM|
Daily walking and the risk of incident functional limitation
in knee osteoarthritis: an observational study
Authors: White DK et al.
Summary: This paper focuses on a substudy of the Multicenter Osteoarthritis (MOST) Study, a large,
multicentre, longitudinal cohort study of community-dwelling participants who have or are at high risk
of knee osteoarthritis (OA). The MOST Study cohort at baseline included adults ages 50–79 years
who were recruited from communities in Alabama and Iowa, starting in 2003. This substudy included
data from the 60-month follow-up examination conducted between May 2009 and January 2011 and
the 84-month follow-up examination conducted between September 2011 and January 2013. For this
analysis, the 60-month visit was considered baseline and the 84-month visit was the 2-year follow-up.
Higher steps/day was associated with less risk of functional limitation over 2 years. Specifically, each
additional 1000 steps/day was associated with a 16% and 18% reduction in incident functional limitation
by performance-based and self-report measures, respectively. Walking <6000 and <5900 steps/day
were the best thresholds to distinguish incident functional limitation by performance-based (sensitivity
67.3%, specificity 71.8%) and self-report (sensitivity 58.7%, specificity 68.9%) measures, respectively.
Comment: Giving people practical advice about exercise is one more challenge to be shoehorned
into a crowded consultation. This study provides simple, practical advice for walking targets for
patients either with or at risk of knee OA. The study was observational using a well-established
cohort, I think they dealt with confounders well, and found that the more you walked, the less likely
you were to develop functional limitations over the next two years. Few who walked more than 3,000
steps a day developed functional impairment, and the more you walked after that, the better, with a
realistic target being 6,000 steps. This is readily measurable using simple pedometers or Bluetooth
enabled movement monitors that connect to your smartphone. The main thing is that this is a simple,
readily describable and prescribable intervention that helps delay functional decline in OA patients.
Reference: Arthritis Care Res (Hoboken). 2014;66(9):1328-36