Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN.
Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Arch Phys Med Rehabil. 2021 Oct;102(10):1888-1894. doi: 10.1016/j.apmr.2021.05.014. Epub 2021 Jun 24.
To examine the association of the volume and intensity of daily walking at baseline with the risk of knee replacement (KR) over 5 years in adults with advanced structural knee osteoarthritis.
Prospective, longitudinal, and multicenter observational study.
Osteoarthritis Initiative study with follow-up from 2008-2015.
Community-dwelling adults with or at risk of knee osteoarthritis were recruited from 4 sites in the United States (N=516; mean age, 67.7±8.6y; body mass index, 29.3±4.7 kg/m; 52% female). We included participants with advanced structural disease, without KR and had valid daily walking data (quantified using Actigraph GT1M), at baseline.
Not applicable.
KR. Walking volume was measured as steps/day and intensity as minutes/day spent not walking (0 steps/min) and walking at very light (1-49 steps/min), light (50-100 steps/min), or moderate (>100 steps/min) intensities. To examine the relationship of walking volume and intensity with the risk of KR, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for covariates.
Of 516 adults with advanced structural disease, 88 received a KR over 5 years (17%). Walking an additional 1000 steps/d was not associated with the risk of KR (adjusted HR=0.95; 95% CI, 0.84-1.04). Statistically, replacing 10 min/d of very light and light walking with 10 min/d of moderate walking reduced the risk of KR incidence by 35% and 37%, respectively (adjusted HR=0.65, 95% CI, 0.45-0.94, for very light and adjusted HR=0.63; 95% CI, 0.40-1.00, for light).
Daily walking volume and intensity did not increase KR risk over 5 years and may be protective in some cases in adults with advanced structural knee osteoarthritis.
在患有晚期结构性膝关节骨关节炎的成年人中，研究基线时每日行走量和强度与 5 年内膝关节置换术（KR）风险的相关性。
前瞻性、纵向、多中心观察性研究。
美国 4 个地点的骨关节炎倡议研究，随访时间为 2008-2015 年。
社区居住的有或有膝关节骨关节炎风险的成年人，从美国 4 个地点招募（N=516；平均年龄 67.7±8.6 岁；体重指数 29.3±4.7 kg/m；52%为女性）。我们纳入了基线时患有晚期结构性疾病、无 KR 且有有效每日行走数据（使用 Actigraph GT1M 进行量化）的参与者。
不适用。
KR。行走量以步数/天表示，强度以不走路（0 步/分钟）和以非常轻（1-49 步/分钟）、轻（50-100 步/分钟）或中高强度（>100 步/分钟）行走的分钟/天表示。为了研究行走量和强度与 KR 风险的关系，我们计算了调整协变量后的危险比（HR）和 95%置信区间（CI）。
在 516 名患有晚期结构性疾病的成年人中，88 人在 5 年内接受了 KR（17%）。每天多走 1000 步与 KR 风险无关（调整后的 HR=0.95；95%CI，0.84-1.04）。统计学上，将每天 10 分钟的非常轻和轻步行分别替换为 10 分钟的中强度步行，可分别降低 KR 发病率 35%和 37%（调整后的 HR=0.65，95%CI，0.45-0.94，非常轻；调整后的 HR=0.63；95%CI，0.40-1.00，轻）。
在患有晚期结构性膝关节骨关节炎的成年人中，每日行走量和强度在 5 年内并未增加 KR 风险，在某些情况下可能具有保护作用。
