Background/Purpose: The 2018 Physical Activity (PA) Guidelines no longer require PA to occur in bouts of ≥ 10 minutes for meeting the weekly 150-min moderate-to-vigorous PA (MVPA) recommendations. In persons with lower limb joint symptoms, attaining 60-min weekly MVPA is linked to maintaining disability-free status over 4 years.  This benchmark serves as an achievable intermediate step toward meeting guidelines and motivates those with chronic knee pain and/or function limitations to engage in PA.  In persons with radiographic knee OA (KOA), 13% men and 8% women met the legacy 2008 PA Guidelines.  It is unknown what proportions of men and women with or at high risk for KOA meet the updated 2018 Guidelines (150-min weekly MVPA) and the disability-free threshold (60-min weekly MVPA).  Factors associated with meeting each threshold have not been examined.  We aimed to (1) describe the prevalence of attaining ≥ 150-min and ≥ 60-min weekly MVPA; and (2) determine factors associated with attaining each of the PA recommendations, in persons with or at high risk for KOA.

Methods: 1922 OAI (Osteoarthritis Initiative) participants with valid accelerometer monitoring at 48-month OAI visit were included in the analysis sample.  We computed weekly unbouted MVPA minutes for each participant.  Radiographic KOA was defined as ≥ K/L 2 in at least 1 knee; symptomatic KOA defined as aching or stiffness for at least half of the days of a month (in the past year) in at least 1 knee.  Descriptive summaries of weekly MVPA minutes are presented separately for men and women.  To identify factors associated with attaining 150-min and 60-min MVPA respectively, we performed multivariate ordered logistic regressions, controlling for age, sex, BMI, race, education, depression, comorbidity, and radiographic/symptomatic KOA.

Results: In those with or at high risk for KOA, 44% men vs. 22% women had ≥ 150 weekly MVPA minutes; 67% men vs. 50% women had ≥ 60 minutes.  In those with radiographic KOA, 41% men vs. 20% women had ≥ 150 minutes; 62% men vs. 47% women had ≥ 60 minutes.  In those with symptomatic KOA, 41% men vs. 16% women had ≥ 150 minutes; 65% men vs. 45% women had ≥ 60 minutes (Table 1). Being a woman, older, obese, overweight, non-White, depressed; and having ≥ 2 comorbidities and both radiographic and symptomatic KOA was each associated with reduced likelihood of attaining the 150-min threshold.  Being a woman, older, obese, overweight, non-college graduate, depressed; and having any comorbidity was each associated with reduced likelihood of attaining the 60-minute threshold.

Conclusion: The proportion of men and women meeting guidelines tripled based the updated 2018 PA Guidelines vs. the legacy 2008 Guidelines. The disparity between sexes widened; twice as many men attained the updated guidelines than women.  PA interventions may explore strategies to engage women, non-Whites, and non-college graduates and target modifiable factors of BMI, depression, and symptom managements.

Table 1

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-eliminating-the-bouted-minutes-requirement-in-the-new-2018-physical-activity-guidelines-for-americans-on-gender-disparity-in-guideline-attainment-for-persons-with-or-at-high-risk-of-knee-ost/