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Abstract Number: 1314

Patient-Specific Reference Values for Objective Physical Function Tests: Cross-Sectional Analysis Using Data from the Osteoarthritis Initiative

Matthew Harkey1, Lori Lyn Price 2, Kieran Reid 3, Grace Lo 4, Shao-Hsien Liu 5, Kate Lapane 1, Lucas Dantas 6, Timothy McAlindon 7 and Jeffrey Driban 7, 1University of Massachusetts Medical School, Worcester, 2Tufts Medical Center, Tufts University, Boston, MA, 3Tufts University, Boston, 4Center of Excellence Michael E. DeBakey VAMC, Baylor College of Medicine, Houston, TX, 5University of Massachusetts Medical School, Worcester, MA, 6Tufts Medical Center, Boston, 7Tufts Medical Center, Boston, MA

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: physical function

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Session Information

Date: Monday, November 11, 2019

Title: Osteoarthritis – Clinical Poster I

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Despite an inter-play between objective physical function measures and various patient characteristics, no large-scale investigations in knee osteoarthritis (KOA) have explored complex interactions or established patient-specific reference values for these tests across sex, age, radiographic severity, and body mass index (BMI). The purpose of this study was to: 1) determine the extent to which interactions among patient characteristics were associated with objective physical function, and 2) use a large community-based cohort of adults with or at risk for KOA to establish patient-specific reference values of objective physical function tests.

Methods: We included participants from the Osteoarthritis Initiative (OAI) with data on objective physical function tests  and patient characteristics (i.e., age, BMI, and radiographic KOA severity: Kellgren-Lawrence Grade [KL]) at the baseline visit. We included three objective physical function tests: 20-meter walk test (20m), chair stand test (CS), and 400-meter test (400m). For the 20m, participants completed two trials at their habitual walking speed. For the CS, participants completed two trials in which they completed sit-to-stands as quickly as possible. For the 400m, participants completed one trial of walking ten 40-meter laps at their habitual walking speed. To determine how each objective physical function is influenced by any combination of these patient characteristics, we used a single linear regression model to evaluate all two-, three-, and four-way interactions. To establish patient-specific reference values for each objective physical function test, we created percentile scores from minimum to maximum in 10% increments for all combinations of the patient characteristics for each test. Subsets for two-way reference values were separated by: sex (male, female); age (five-year increments from 45-80 years); KL (KL0 – KL4); and BMI (18.5-25 kg/m2, 25-30 kg/m2, 30-35 kg/m2, >35 kg/m2). Due to smaller subset sample sizes, three- and four-way references were separated by: age (45-60, 60-70, and 70-80 years); KL (KL0/1, KL2, KL3/4); and BMI (18.5-25 kg/m2, 25-30 kg/m2, >30 kg/m2).

Results: We included 3,880 individuals who were on average 61+9 years old with a BMI of 29+5 kg/m2. For all physical function tests, there was no statistically significant four-way interaction between sex, age, KL, and BMI (Table 1). However, all physical function tests had at least one significant three-way or two-way interaction. Figure 1 highlights the interaction between sex, KL, and BMI for the 400m. We created reference value tables for each physical function test across all combinations of patient characteristics for two-, three-, and four-way interactions. Table 2 provides an example of two- and three-way interaction tables for the 400m.

Conclusion: Rather than rely on a single cut-off for all adults with or at risk for KOA, our analysis highlights the need for reference values within clinically relevant subsets that indicate a patient’s relative level of physical function. Further work is needed convert these extensive reference value tables to a format that can be easily translated into clinical practice.


Table1

Table 1. Regression Analysis Results Highlighting the Interaction Between Patient Characteristics that Relate with Objective Physical Function Tests. BMI = body mass index, KL = Kellgren-Lawrence Grade, p = regression analysis interaction p-value, *: p<0.05


Figure1

Figure 1. 400-Meter Walk Performance by Sex, KL Grade, and BMI Category. Greater median 400-meter walk time indicates worse objective physical function; KL = Kellgren-Lawrence Grade


Table2

Table 2. Reference Values for 400-meter Walk Time Across a Two-Way and Three-Way Combination of Patient Characteristics. KL = Kellgren-Lawrence, BMI = body mass index, n = sample size. 50% = median. All values in meter per second.


Disclosure: M. Harkey, None; L. Price, None; K. Reid, None; G. Lo, None; S. Liu, None; K. Lapane, None; L. Dantas, None; T. McAlindon, None; J. Driban, Pfizer, Inc., 8.

To cite this abstract in AMA style:

Harkey M, Price L, Reid K, Lo G, Liu S, Lapane K, Dantas L, McAlindon T, Driban J. Patient-Specific Reference Values for Objective Physical Function Tests: Cross-Sectional Analysis Using Data from the Osteoarthritis Initiative [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/patient-specific-reference-values-for-objective-physical-function-tests-cross-sectional-analysis-using-data-from-the-osteoarthritis-initiative/. Accessed .
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