Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE, USA; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE, USA; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA.
Osteoarthritis Cartilage. 2020 Dec;28(12):1551-1558. doi: 10.1016/j.joca.2020.08.009. Epub 2020 Aug 28.
OBJECTIVE: Adults with radiographic knee OA (rKOA) are at increased risk of mortality and walking difficulty may modify this relation. Little is known about specific aspects of walking difficulty that increase mortality risk. We investigated the association of walking speed (objective measure of walking difficulty) with mortality and examined the threshold that best discriminated this risk in adults with rKOA. METHODS: Participants with rKOA from the Johnston County Osteoarthritis Project (JoCoOA, longitudinal population-based cohort), Osteoarthritis Initiative and Multicenter Osteoarthritis Study (OAI and MOST, cohorts of individuals with or at high risk of knee OA) were included. Baseline speed was measured via 2.4-meter (m) walk test (short-distance) in JoCoOA and 20-m walk test (standard-distance) in OAI and MOST. To examine the association of walking speed with mortality risk over 9 years, hazard ratios (HR) and 95% confidence intervals (CI) were calculated from Cox regression models adjusted for potential confounders. A Maximal Likelihood Ratio Chi-square Approach was utilized to identify an optimal threshold of walking speed predictive of mortality. RESULTS: Deaths after 9 years of follow-up occurred in 23.3% (290/1244) of JoCoOA and 5.9% (249/4215) of OAI + MOST. Walking 0.2 m/s slower during short- and standard-distance walk tests was associated with 23% (aHR [95%CI]; 1.23 [1.10, 1.39]) and 25% (1.25 [1.09, 1.43]) higher mortality risk, respectively. Walking <0.5 m/s on short-distance and <1.2 m/s standard-distance walk tests, best discriminated those with and without mortality risk. CONCLUSION: Slower walking speed measured via short- and standard-distance walk tests was associated with increased mortality risk in adults with rKOA.
目的:有放射影像学膝关节骨关节炎(rKOA)的成年人死亡风险增加,行走困难可能会改变这种关系。对于增加死亡风险的特定行走困难方面知之甚少。我们研究了行走速度(行走困难的客观测量)与死亡率的关系,并检查了 rKOA 成年人中最佳区分这种风险的阈值。
方法:纳入了来自约翰斯顿县骨关节炎项目(JoCoOA,纵向人群队列)、骨关节炎倡议和多中心骨关节炎研究(OAI 和 MOST,有或高膝关节骨关节炎风险的个体队列)的 rKOA 患者。JoCoOA 中通过 2.4 米(m)步行测试(短距离)和 OAI 和 MOST 中的 20 米步行测试(标准距离)测量基线速度。为了检查 9 年内行走速度与死亡率风险的关系,使用 Cox 回归模型计算了调整潜在混杂因素后的危险比(HR)和 95%置信区间(CI)。使用最大似然比卡方方法确定了预测死亡率的最佳行走速度阈值。
结果:9 年随访后发生死亡的有 23.3%(290/1244)的 JoCoOA 和 5.9%(249/4215)的 OAI+MOST。短距离和标准距离步行测试时行走速度慢 0.2m/s 与 23%(aHR[95%CI];1.23[1.10, 1.39])和 25%(1.25[1.09, 1.43])更高的死亡率风险相关。短距离行走速度<0.5m/s 和标准距离行走速度<1.2m/s 最佳区分了有和无死亡风险的患者。
结论:rKOA 成年人短距离和标准距离步行测试时行走速度较慢与死亡率风险增加相关。
Arthritis Care Res (Hoboken). 2021-4
Arthritis Care Res (Hoboken). 2012-7
Arthritis Care Res (Hoboken). 2025-3
Arthritis Care Res (Hoboken). 2025-3
Arthritis Care Res (Hoboken). 2023-9
Arthritis Care Res (Hoboken). 2021-4
JAMA Intern Med. 2019-8-1
Osteoarthritis Cartilage. 2018-12-22
Arthritis Care Res (Hoboken). 2018-5-6
Osteoarthritis Cartilage. 2015-3-25
J Aging Phys Act. 2015-4