工作和休闲时膝关节疼痛与膝关节负荷体力活动之间的关联——一项基于加速度计测量的横断面研究

Associations between knee pain and knee-loading physical activities at work and leisure - a cross-sectional study based on accelerometer measurements.

作者信息

Törnblom Margareta, Haglund Emma, Bremander Ann, Nilsdotter Anna, Andersson Maria LE, Hettiarachchi Pasan, Johansson Peter J, Svartengren Magnus, Aili Katarina

机构信息

Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.

Spenshult Research and Development Centre, Halmstad, Sweden.

出版信息

BMC Musculoskelet Disord. 2025 Apr 8;26(1):345. doi: 10.1186/s12891-025-08589-w.

DOI:10.1186/s12891-025-08589-w

PMID:40200207

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11980322/

Abstract

BACKGROUND

Knee pain is often an early sign of knee osteoarthritis (KOA). Physical activities (PA) constitute the recommended regime to those affected. However, knee-loading PA at work is linked to an increased risk for KOA. The primary aim of this study was to investigate associations between knee pain and accelerometer-measured knee-loading PA, at work and leisure respectively. The secondary aim was to investigate knee-related problems in relation to self-reported physical effort at work.

METHODS

This cross-sectional study included 107 working participants (aged 30-67) with knee pain. Knee pain was evaluated using the Knee Injury and Osteoarthritis Outcome Scale (KOOS), subscale Pain. Knee-loading PA (including daily steps, time in upright position, stair walking), and sitting/lying were measured by accelerometer for one week. Each knee-loading PA was analysed separately for the measurement periods: (1) total period, (2) time at work, and (3) leisure on workdays. Knee-related problems were evaluated by the KOOS subscales Symptoms, Activities of Daily Living, Function in Sport and Recreation, and Quality of Life. Analyses were made with linear regression, and stratified by high or low self-reported physical effort at work.

RESULTS

Participants with more knee pain walked on average fewer steps per day, and spent less time in an upright position during leisure on workdays, unstandardized coefficient (β) = 0.001, p = 0.044, β = 0.075, p = 0.001 respectively, i.e. spent less time in knee-loading PA. The associations were stronger for those reporting high physical effort at work, β = 0.116, p = 0.016. Participants with high physical effort at work rated their (knee-related) quality of life worse. There were no associations between knee pain and knee-loading PA during work hours.

CONCLUSIONS

Participants with more knee pain were less physically active during leisure, with stronger associations among those with higher physical effort at work. Those reporting high physical effort at work had worse (knee-related) quality of life compared to participants reporting low effort at work. This highlights the importance of taking knee-loading PA at work and leisure into account when recommending exercise regimes to individuals with knee pain.

TRIAL REGISTRATION

ClinicalTrials.Gov (NCT04928170), Date of registration: 2017-12-20.

摘要

背景

膝关节疼痛通常是膝骨关节炎（KOA）的早期症状。体育活动（PA）是推荐给患者的治疗方案。然而，工作中的膝关节负重体育活动与患KOA的风险增加有关。本研究的主要目的是分别调查工作和休闲时膝关节疼痛与加速度计测量的膝关节负重体育活动之间的关联。次要目的是调查与工作中自我报告的体力消耗相关的膝关节问题。

方法

这项横断面研究纳入了107名有膝关节疼痛的在职参与者（年龄在30 - 67岁之间）。使用膝关节损伤和骨关节炎疗效评分量表（KOOS）中的疼痛子量表评估膝关节疼痛。通过加速度计测量一周的膝关节负重体育活动（包括每日步数、直立时间、上下楼梯）以及坐姿/躺姿时间。对每个膝关节负重体育活动在以下测量时间段分别进行分析：（1）总时间段；（2）工作时间；（3）工作日的休闲时间。通过KOOS子量表中的症状、日常生活活动、运动和娱乐功能以及生活质量来评估与膝关节相关的问题。采用线性回归分析，并根据工作中自我报告的体力消耗高低进行分层。

结果

膝关节疼痛较严重的参与者平均每天走的步数更少，在工作日休闲时直立的时间更短，未标准化系数（β）分别为 = 0.001，p = 0.044，β = 0.075，p = 0.001，即膝关节负重体育活动的时间更少。对于工作中体力消耗高的参与者，这种关联更强，β = －0.116，p = 0.016。工作中体力消耗高的参与者对其（与膝关节相关的）生活质量评价更差。工作时间内膝关节疼痛与膝关节负重体育活动之间没有关联。