Miller M E, Rejeski W J, Messier S P, Loeser R F
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1063, USA.
Arthritis Rheum. 2001 Aug;45(4):331-9. doi: 10.1002/1529-0131(200108)45:4<331::AID-ART345>3.0.CO;2-6.
To ascertain predictors of decline in physical functioning among older adults reporting knee pain.
The Observational Arthritis Study in Seniors was a longitudinal study of 480 adults over 65 years of age. Measurements of strength, sociodemographic characteristics, disease burden (including radiographic knee osteoarthritis [OA]), self-reported disability, and functional limitations were obtained on participants at baseline and at 15 and 30 months.
Radiographic evidence of OA at baseline was moderately associated with an increased decline in both transfer (P = 0.06) and ambulatory-based performance tasks (P = 0.04) but not in self-reported disability. This effect disappeared after accounting for baseline levels of knee pain intensity and knee strength.
Knee pain intensity and knee strength may mediate the relationship between radiographic evidence of knee OA and change in performance. Although it is not clear whether joint disease precedes or follows a decline in muscular strength, these results may help to identify subpopulations of older persons with knee OA who may benefit from interventions aimed at slowing the progression of disability related to transfer and ambulatory-based tasks.
确定报告有膝关节疼痛的老年人身体功能下降的预测因素。
老年人观察性关节炎研究是一项针对480名65岁以上成年人的纵向研究。在基线、15个月和30个月时对参与者进行了力量、社会人口学特征、疾病负担（包括膝关节影像学骨关节炎[OA]）、自我报告的残疾情况以及功能受限情况的测量。
基线时OA的影像学证据与转移（P = 0.06）和基于步行的性能任务（P = 0.04）下降增加呈中度相关，但与自我报告的残疾情况无关。在考虑膝关节疼痛强度和膝关节力量的基线水平后，这种效应消失。
膝关节疼痛强度和膝关节力量可能介导膝关节OA的影像学证据与性能变化之间的关系。虽然尚不清楚关节疾病是先于还是后于肌肉力量下降出现，但这些结果可能有助于识别患有膝关节OA的老年亚组人群，他们可能受益于旨在减缓与转移和基于步行的任务相关的残疾进展的干预措施。
