Halliwell Carson, O'Brien Myles, Moyer Rebecca
School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, Canada.
Department of Medicine, Faculty of Medicine and Health Science, Sherbrooke University, Sherbrooke, Canada.
Musculoskeletal Care. 2025 Mar;23(1):e70046. doi: 10.1002/msc.70046.
Osteoarthritis is a progressive joint disease that causes pain and disability, impairing physical function. Moderate-to-vigorous physical activity (MVPA) is recommended for knee osteoarthritis, while stationary time, independent of activity, may negatively impact health outcomes. We hypothesised that individuals with the highest MVPA and lowest stationary time would have better long-term function compared to those with the lowest MVPA and highest stationary time, as well as those with high levels of both MVPA and stationary time.
Data included 442 participants, with an average age of 66-years and 190-females from the Osteoarthritis Initiative who wore accelerometers to assess MVPA and stationary time. Participants were grouped into tertiles of MVPA and stationary time normalised to total accelerometer wear time. The three groups were: highest activity, lowest stationary (HALS), highest activity, highest stationary (HAHS), and lowest activity, highest stationary (LAHS). Gait speed, the 400 m walk test, and five-time repeated chair stand were assessed at baseline and four-year follow-up.
Compared to the LAHS group, the HALS and HAHS groups had better performance in gait speed p < 0.001, d = 0.96-1.06, 400m walk time p < 0.001, d = 1.21-1.36, and five-time repeated chair stand p < 0.001, d = 0.54-0.81 at baseline and four-year follow-up. No differences were found between the HALS and HAHS groups at either timepoint.
Higher levels of MVPA were associated with better lower-limb functional outcomes in individuals with or at risk of knee osteoarthritis. Higher levels of stationary time do not negatively influence functional performance as long as higher numbers of MVPA levels (∼30 min/day) are achieved.
骨关节炎是一种会导致疼痛和残疾、损害身体功能的进行性关节疾病。对于膝骨关节炎患者,建议进行中度至剧烈的体育活动(MVPA),而不考虑活动情况的静息时间可能会对健康结果产生负面影响。我们假设,与MVPA最低且静息时间最长的个体以及MVPA和静息时间都高的个体相比,MVPA最高且静息时间最短的个体长期功能会更好。
数据包括来自骨关节炎倡议组织的442名参与者,平均年龄66岁,其中190名为女性,他们佩戴加速度计以评估MVPA和静息时间。参与者被分为MVPA和静息时间的三分位数组,这些数值根据加速度计的总佩戴时间进行了标准化。这三组分别是:最高活动量、最低静息时间组(HALS),最高活动量、最高静息时间组(HAHS),以及最低活动量、最高静息时间组(LAHS)。在基线和四年随访时评估了步速、400米步行测试和五次重复坐立试验。
与LAHS组相比,HALS组和HAHS组在基线和四年随访时的步速(p < 0.001,d = 0.96 - 1.06)、400米步行时间(p < 0.001,d = 1.21 - 1.36)和五次重复坐立试验(p < 0.001,d = 0.54 - 0.81)表现更好。在两个时间点上,HALS组和HAHS组之间均未发现差异。
对于患有膝骨关节炎或有患膝骨关节炎风险的个体,较高水平的MVPA与更好的下肢功能结果相关。只要达到较高的MVPA水平(约每天30分钟),较高水平的静息时间不会对功能表现产生负面影响。