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Abstract Number: 2027

The Association of Light and Moderate-to-Vigorous Walking with Incident Poor Health Outcomes over Two Years in People with or at High Risk of Knee Osteoarthritis

Sally Fenton1,2, Joan Duda3, Rainer Klocke4, Abishek Abishek5, Alison Rushton3, Michael Doherty6, Weiya Zhang7, George D. Kitas2, Tuhina Neogi8, Michael Nevitt9, Cora E Lewis10, James Torner11, Dorothy D. Dunlop12 and Daniel White13, 1School of Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, United Kingdom, 2Department of Rheumatology, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust, Dudley, United Kingdom, 3School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK, Birmingham, United Kingdom, 4Rheumatology Department, The Dudley Group of Hospitals NHS Foundation Trust, Dudley, United Kingdom, 5Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom, 6University of Nottingham, Nottingham, United Kingdom, 7Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom, 8Clinical Epidemiology, Boston University School of Medicine, Boston, MA, 9Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA, 10Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, 11University of Iowa, UIowa, Iowa City, IA, 12Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, 13Department of Physical Therapy, University of Delaware, Newark, DE

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Co-morbidities, gait, Multicenter study, Osteoarthritis and physical activity

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Session Information

Date: Monday, November 14, 2016

Session Title: ACR/ARHP Combined Abstract Session: Epidemiology and Pubic Health

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose:  Regular engagement in physical activity reduces the risk adverse health outcomes such as cardiovascular diseases, functional limitation, and depression in people with knee osteoarthritis (OA). While walking is the most common form of physical activity for older adults, the relative health benefits of walking at a light intensity and at a moderate-to-vigorous intensity are unclear. The primary purpose of this study was to investigate the association of replacing ‘no-walking’ with different intensities of walking, with risk of developing adverse health outcomes over two years among people with or at high risk of knee OA.

Methods:  The Multicenter Osteoarthritis Study (MOST) is a NIH-funded longitudinal cohort of older adults who have or are at high risk of knee OA. Steps/day over 7 days were objectively measured with a StepWatch monitor at the 60-month MOST study visit. Walking was classified in minutes per day (min/day) of no-walking (<1 step/minute), very-light walking (1 – 50 steps/min), moderately-light walking (51 – 100 steps/min) and moderate-to-vigorous walking (>100 steps/min). Incident outcomes were slow gait speed during a 20-meter walk (<1 metre/second), comorbidity (Charlson index ≥1), depressive symptoms (CES-D ≥16) and low balance confidence (Activities-specific Balance Confidence scale <67) assessed 2 years post 60-month MOST study visit (i.e., 84-month MOST study visit). Isotemporal substitution analysis was conducted to evaluate the effect of replacing 10 minutes of ‘no-walking’ with 10 minutes of walking at very-light, moderately-light and moderate-to-vigorous intensities, with study outcomes. All models were adjusted for age, sex, BMI, study site, race, education, marital status and lower limb pain.

Results: Of the 1782 subjects who wore the StepWatch for ≥3 days (Age 67.3 ± 7.7, 60% women, BMI 30.7 ± 5.9), incidence of poor health outcomes ranged from 5.6% for depressive symptoms (82/1460) to 16.6% for slow gait speed (251/1514). Replacing 10 minutes of no-walking with 10 minutes of moderate-to-vigorous walking per/day was associated with modest reductions in the risk of slow gate speed and low balance confidence (RR = 0.75 and 0.81, respectively), though low balance confidence bordered on significance (p =.05) (Table 1). Replacing 10 minutes of no-walking with 10 minutes of very-light walking per/day was associated with a small reduction in risk of comorbidity (RR = 0.97).

Conclusion: Findings indicate the presence of a dose-response relationship with regards to walking intensity and pertinent health outcomes in people with, or at high risk of OA. Specifcally, replacing no-walking with just 10 minutes of walking at increasing intensities each day may hold positive consequences for preserving functional gate speed, sustaining confidence with regards to functional capacity (i.e., balance confidence), and reducing risk of comorbidity. Table 1.Adjusted risk ratios

Risk of Incident Slow Gait Speed at 2 years (< 1.0 m/s)

N = 1514

Risk of Depressive symptoms at 2 years (CES-D > 16)

N = 1460

Risk of Comorbidity at 2 years (Charlson > 1)

N = 1238

Risk of Low Balance Confidence (ABC < 67)

N = 1578

 

Adjusted* Risk Ratio

95% CI

Adjusted* Risk Ratio

 

95% CI

Adjusted* Risk Ratio

95% CI

Adjusted* Risk Ratio

95% CI

Replace 10 minutes of no-walking with 10 minutes of very-light walking (1 – 50 steps/min)

0.99

0.97, 1.01

1.00

0.97, 1.04

0.97

0.95, 1.00

0.99

0.97, 1.01

Replace 10 minutes of no-walking with 10 minutes of moderately-light walking (50 – 100 steps/min)

0.94

0.87, 1.01

1.10

0.98, 1.25

1.00

0.91, 1.11

0.94

0.86, 1.02

Replace 10 minutes of no-walking with 10 minutes moderate-to-vigorous walking (> 100 steps/min)

0.75

0.61, 0.92

0.82

0.60, 1.11

0.77

0.58, 1.02

0.81

0.65, 1.00


Disclosure: S. Fenton, None; J. Duda, None; R. Klocke, None; A. Abishek, None; A. Rushton, None; M. Doherty, None; W. Zhang, None; G. D. Kitas, None; T. Neogi, None; M. Nevitt, None; C. E. Lewis, None; J. Torner, None; D. D. Dunlop, None; D. White, None.

To cite this abstract in AMA style:

Fenton S, Duda J, Klocke R, Abishek A, Rushton A, Doherty M, Zhang W, Kitas GD, Neogi T, Nevitt M, Lewis CE, Torner J, Dunlop DD, White D. The Association of Light and Moderate-to-Vigorous Walking with Incident Poor Health Outcomes over Two Years in People with or at High Risk of Knee Osteoarthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-association-of-light-and-moderate-to-vigorous-walking-with-incident-poor-health-outcomes-over-two-years-in-people-with-or-at-high-risk-of-knee-osteoarthritis/. Accessed May 27, 2023.
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