Department of Physical Therapy, School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, USA.
RTI International, Technology Advancement and Commercialization, Research Triangle Park, North Carolina, USA.
PM R. 2024 Jun;16(6):532-542. doi: 10.1002/pmrj.13082. Epub 2023 Nov 27.
Individuals with end-stage knee osteoarthritis (OA) walk at a lower intensity (ie, slower step cadence) contributing to worse physical function. Previous literature reports daily step counts and sedentary time, with little information regarding stepping bouts or cadence. Determining relationships between daily higher stepping cadence duration and clinical outcomes can move the field toward optimal daily stepping prescription.
To quantify daily physical activity patterns of individuals with end-stage knee OA and determine the contribution of high stepping cadence to explain functional capacity variability.
Cross-sectional analysis.
Veterans Administration medical center.
U.S. military veterans (n = 104; age: 67.1 years [7.2]; mean [SD]; male [89.3%]) with end-stage knee OA were enrolled.
Not applicable.
Functional capacity (6-Minute Walk Test [6MWT]). Physical activity (activPAL wearable sensor; cadence and time sitting, standing, and stepping), pain (Western Ontario and McMaster Universities Osteoarthritis Index-pain subscale) sociodemographic variables, and comorbidities (body mass index and Functional Comorbidity Index) are the main explanatory variables.
Participants' wake time was mainly sitting (11.0 h/day) in ≥60-minute bouts (29.7% ± 12.7 of sitting time). Standing (3.4 hours/day) and stepping (1.4 h/day) primarily occurred in 0-5 minute bouts (standing: 87.7% ± 14.4 of standing time, stepping: 98.7% ± 12.7 of stepping time) and stepping cadence was predominantly incidental (1-19 spm; 52.9% ± 9.6 of total stepping time). Backward elimination model results indicated shorter medium-to-brisk cadence bout duration, older age, and higher pain significantly explained shorter 6MWT distance (R=0.24, p < .01).
Individuals with knee OA spend most of their waking hours sitting, while standing and stepping occurs in short bouts at very low stepping cadence. Decreased time in high stepping cadence is associated with lower functional capacity. Future studies should explore if increasing the daily time spent in higher step cadence can improve functional capacity in this population.
终末期膝骨关节炎（OA）患者的步行强度较低（即步频较慢），导致身体机能更差。先前的文献报告了日常步数和久坐时间，但关于步幅或步频的信息较少。确定日常高步频持续时间与临床结果之间的关系，可以推动该领域朝着最佳日常步幅处方的方向发展。
量化终末期膝骨关节炎患者的日常身体活动模式，并确定高步频对解释功能能力变异性的贡献。
横断面分析。
退伍军人管理局医疗中心。
招募了 104 名美国退伍军人（年龄：67.1 岁[7.2]；平均[标准差]；男性[89.3%]）患有终末期膝骨关节炎。
不适用。
功能能力（6 分钟步行测试[6MWT]）。身体活动（activPAL 可穿戴传感器；步频和坐、站、走时间）、疼痛（安大略西部和麦克马斯特大学骨关节炎指数-疼痛子量表）、社会人口统计学变量和合并症（体重指数和功能合并症指数）是主要的解释变量。
参与者的清醒时间主要为坐着（11.0 小时/天），持续时间≥60 分钟（29.7%±12.7 的坐着时间）。站立（3.4 小时/天）和行走（1.4 小时/天）主要发生在 0-5 分钟的时间段（站立：87.7%±14.4 的站立时间，行走：98.7%±12.7 的行走时间），且步频主要为偶发性（1-19 spm；52.9%±9.6 的总行走时间）。逐步向后消除模型结果表明，中等至高步频的短暂持续时间、年龄较大和疼痛较高显著解释了 6MWT 距离较短（R=0.24，p<.01）。
膝骨关节炎患者在清醒时大部分时间都坐着，而站立和行走则以非常低的步频短时间发生。高步频的时间减少与功能能力降低有关。未来的研究应该探讨是否增加日常高步频的时间可以提高该人群的功能能力。
