H. Master, PT, PhD, MPH, Department of Physical Therapy, College of Health Sciences, and Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, Delaware, and Department of Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
L.M. Thoma, PT, DPT, PhD, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
J Rheumatol. 2021 Sep;48(9):1458-1464. doi: 10.3899/jrheum.201250. Epub 2021 Feb 1.
To examine the joint association of moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior with the risk of developing functional limitation 4 years later in adults with knee osteoarthritis (OA).
Using 48-month (baseline) accelerometry data from the Osteoarthritis Initiative, we classified participants as Active-Low Sedentary (≥ 1 10-min bout/week of MVPA, lowest tertile for standardized sedentary time), Active-High Sedentary (≥ 1 10-min bout/week of MVPA, top 2 tertiles for standardized sedentary time), Inactive-Low Sedentary (zero 10-min bouts/week of MVPA, lowest tertile for standardized sedentary time), and Inactive-High Sedentary (zero 10-minute bouts/week of MVPA, top 2 tertiles for standardized sedentary time) groups. Functional limitation was defined as > 12 seconds for the 5-repetition sit-to-stand test (5XSST) and < 1.22 m/s gait speed during the 20-meter walk test. To investigate the association of exposure groups with risk of developing functional limitation 4 years later, we calculated adjusted risk ratios (aRR; adjusted for potential confounders).
Of 1091 and 1133 participants without baseline functional limitation, based on the 5XSST and 20-meter walk test, respectively, 15% and 21% developed functional limitation 4 years later. The Inactive-Low Sedentary and Inactive-High Sedentary groups had increased risk of developing functional limitations compared to the Active-Low Sedentary and Active-High Sedentary groups. The Inactive-Low Sedentary group had 72% (aRR 1.72, 95% CI 1.00-2.94) and 52% (aRR 1.52, 95% CI 1.03-2.25) more risk of developing functional limitation based on the 5XSST and 20-meter walk test, respectively, compared to the Active-Low Sedentary group.
Regardless of sedentary category, being inactive (zero 10-min bouts/week in MVPA) may increase the risk of developing functional limitation in adults with knee OA.
探讨成年人膝关节骨关节炎（OA）患者在 4 年内出现功能障碍的风险与中高强度体力活动（MVPA）和久坐行为的联合相关性。
使用 Osteoarthritis Initiative 的 48 个月（基线）加速计数据，我们将参与者分为以下 4 组：活跃低久坐组（≥每周 1 次 10 分钟以上的 MVPA，标准久坐时间最低三分位）、活跃高久坐组（≥每周 1 次 10 分钟以上的 MVPA，标准久坐时间前 2 个三分位）、不活跃低久坐组（每周 0 次 10 分钟以上的 MVPA，标准久坐时间最低三分位）和不活跃高久坐组（每周 0 次 10 分钟以上的 MVPA，标准久坐时间前 2 个三分位）。功能障碍的定义为 5 次重复坐站测试（5XSST）> 12 秒和 20 米步行测试中速度< 1.22 m/s。为了研究暴露组与 4 年后发生功能障碍的风险之间的关联，我们计算了调整后的风险比（aRR；调整了潜在混杂因素）。
在基于 5XSST 和 20 米步行测试分别没有基线功能障碍的 1091 名和 1133 名参与者中，15%和 21%的人在 4 年后出现了功能障碍。与活跃低久坐组和活跃高久坐组相比，不活跃低久坐组和不活跃高久坐组发生功能障碍的风险增加。与活跃低久坐组相比，不活跃低久坐组出现功能障碍的风险分别增加了 72%（aRR 1.72，95%CI 1.00-2.94）和 52%（aRR 1.52，95%CI 1.03-2.25），分别基于 5XSST 和 20 米步行测试。
无论久坐行为如何，不活跃（MVPA 中每周 0 次 10 分钟以上）可能会增加膝关节 OA 成年人出现功能障碍的风险。
