Active Therapies -Physiotherapy and Osteopathy

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