Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
The Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
BMC Musculoskelet Disord. 2024 Jul 26;25(1):586. doi: 10.1186/s12891-024-07710-9.
To identify physical activity (PA) trajectories in adults with or at risk of knee osteoarthritis and to evaluate the association of PA trajectories with incident knee replacement (KR).
This study used data from the Osteoarthritis Initiative. The Physical Activity Scale for the Elderly and the KR were assessed annually from baseline to 9 years. Individuals were included if they did not undergo KR surgery at baseline and had data on PA at ≥ 1 visit before KR. Latent class growth mixture Modeling was used to identify the optimal trajectories of PA before KR. Log-binomial regression models were used to assess the association between PA trajectories and the risk of KR. Data analyses were conducted in all individuals and those with radiographic osteoarthritis (ROA) and significant knee pain (Western Ontario and McMaster Osteoarthritis Index pain score of ≥ 5 on a 0-20 scale) at baseline, respectively.
Of 4731 participants (mean age 61.1 years, 58.5% female), four distinct and slightly declined PA trajectories were identified. Compared to individuals with a "Low" PA trajectory, those with "Medium-low", "Medium-high", or "High" PA trajectories were not significantly associated with the risk of KR (risk ratios: 0.97-1.19, all p > 0.05). Similar PA trajectories and associations with the risk of KR were observed in the subgroups of individuals with radiographic osteoarthritis and those with significant knee pain at baseline, respectively.
In participants with or at risk of knee osteoarthritis, PA slightly declines over time and may play no role in the risk of KR.
本研究旨在识别膝骨关节炎患者或高危人群的体力活动（PA）轨迹，并评估 PA 轨迹与膝关节置换（KR）事件的相关性。
本研究使用了来自 Osteoarthritis Initiative 的数据。使用老年体力活动量表和 KR 从基线到 9 年进行每年评估。如果患者基线时未接受 KR 手术，且在 KR 前至少有 1 次 PA 数据，则纳入研究。采用潜在类别增长混合模型识别 KR 前 PA 的最佳轨迹。采用对数二项式回归模型评估 PA 轨迹与 KR 风险之间的关系。分别在所有个体、基线时存在放射学骨关节炎（ROA）和膝关节显著疼痛（Western Ontario 和 McMaster Osteoarthritis Index 疼痛评分≥20 分的 5 分）的个体中进行数据分析。
在 4731 名参与者中（平均年龄 61.1 岁，58.5%为女性），确定了四个不同且略有下降的 PA 轨迹。与“低”PA 轨迹的个体相比，“中低”、“中高”或“高”PA 轨迹的个体与 KR 风险无显著相关性（风险比：0.97-1.19，均 P>0.05）。在基线时存在放射学骨关节炎和膝关节显著疼痛的亚组中，也观察到了相似的 PA 轨迹和与 KR 风险的相关性。
在膝骨关节炎患者或高危人群中，PA 随时间呈轻微下降趋势，可能与 KR 风险无关。
