Sliepen Maik, Mauricio Elsa, Lipperts Matthijs, Grimm Bernd, Rosenbaum Dieter
Institut für Experimentelle Muskuloskelettale Medizin (IEMM), Universitätsklinikum Münster (UKM), Westfälische Wilhelms-Universität Münster (WWU), Albert-Schweitzer Campus 1, Gebäude D3, 48129, Münster, Germany.
AHORSE, Department of Orthopaedics, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419, PC, Heerlen, the Netherlands.
BMC Musculoskelet Disord. 2018 Feb 23;19(1):64. doi: 10.1186/s12891-018-1980-3.
Knee osteoarthritis patients may become physically inactive due to pain and functional limitations. Whether physical activity exerts a protective or harmful effect depends on the frequency, intensity, time and type (F.I.T.T.). The F.I.T.T. dimensions should therefore be assessed during daily life, which so far has hardly been feasible. Furthermore, physical activity should be assessed within subgroups of patients, as they might experience different activity limitations. Therefore, this study aimed to objectively describe physical activity, by assessing the F.I.T.T. dimensions, and sedentary behaviour of knee osteoarthritis patients during daily life. An additional goal was to determine whether activity events, based on different types and durations of physical activity, were able to discriminate between subgroups of KOA patients based on risk factors.
Clinically diagnosed knee osteoarthritis patients (according to American College of Rheumatology criteria) were monitored for 1 week with a tri-axial accelerometer. Furthermore, they performed three functional tests and completed the Knee Osteoarthritis Outcome Score. Physical activity levels were described for knee osteoarthritis patients and compared between subgroups.
Sixty-one patients performed 7303 mean level steps, 319 ascending and 312 descending steps and 601 bicycle crank revolutions per day. Most waking hours were spent sedentary (61%), with 4.6 bouts of long duration (> 30 min). Specific events, particularly ascending and descending stairs/slopes, brief walking and sedentary bouts and prolonged walking bouts, varied between subgroups.
From this sample of KOA patients, the most common form of activity was level walking, although cycling and stair climbing activities occurred frequently, highlighting the relevance of distinguishing between these types of PA. The total active time encompassed a small portion of their waking hours, as they spent most of their time sedentary, which was exacerbated by frequently occurring prolonged bouts. In this study, event-based parameters, such as stair climbing or short bouts of walking or sedentary time, were found more capable of discriminating between subgroups of KOA patients compared to overall levels of PA and sedentary time. Thereby, subtle limitations in physical behaviour of KOA-subgroups were revealed, which might ultimately be targeted in rehabilitation programs.
German Clinical Trials Registry under ' DRKS00008735 ' at 02.12.2015.
膝关节骨关节炎患者可能因疼痛和功能受限而身体活动减少。体力活动产生保护作用还是有害作用取决于频率、强度、时间和类型（F.I.T.T.原则）。因此，应在日常生活中评估F.I.T.T.原则的各个维度，而这在目前几乎是不可行的。此外，应在患者亚组内评估体力活动，因为他们可能经历不同的活动限制。因此，本研究旨在通过评估F.I.T.T.原则的各个维度，客观描述膝关节骨关节炎患者在日常生活中的体力活动和久坐行为。另一个目标是确定基于不同类型和持续时间的体力活动的活动事件是否能够根据危险因素区分膝关节骨关节炎患者的亚组。
对临床诊断为膝关节骨关节炎的患者（根据美国风湿病学会标准）使用三轴加速度计监测1周。此外，他们进行了三项功能测试并完成了膝关节骨关节炎结局评分。描述了膝关节骨关节炎患者的体力活动水平，并在亚组之间进行比较。
61名患者平均每天进行7303步平地行走、319次上楼和312次下楼以及601次自行车曲柄转动。大多数清醒时间都处于久坐状态（61%），有4.6次长时间（>30分钟）的久坐时段。特定活动事件，尤其是上下楼梯/斜坡、短时间行走和久坐时段以及长时间行走时段，在亚组之间有所不同。
在这个膝关节骨关节炎患者样本中，最常见的活动形式是平地行走，尽管骑自行车和爬楼梯活动也经常发生，这突出了区分这些类型的体力活动的重要性。总的活跃时间只占他们清醒时间的一小部分，因为他们大部分时间都处于久坐状态，而且经常出现的长时间久坐时段使这种情况更加严重。在本研究中，发现基于事件的参数，如爬楼梯、短时间行走或久坐时间，比总体体力活动水平和久坐时间更能区分膝关节骨关节炎患者的亚组。由此揭示了膝关节骨关节炎亚组在身体行为方面的细微限制，这些限制最终可能成为康复计划的目标。
德国临床试验注册中心，注册号为“DRKS00008735”，注册时间为2015年12月2日。
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