No Association between Daily Walking and Knee Structural Changes in People at Risk of or with Mild Knee Osteoarthritis. Prospective Data from the Multicenter Osteoarthritis Study

doi:10.3899/jrheum.150071

Multicenter Study

. 2015 Sep;42(9):1685-93.

doi: 10.3899/jrheum.150071. Epub 2015 Jun 15.

No Association between Daily Walking and Knee Structural Changes in People at Risk of or with Mild Knee Osteoarthritis. Prospective Data from the Multicenter Osteoarthritis Study

Britt Elin Øiestad¹, Emily Quinn², Daniel White², Frank Roemer², Ali Guermazi², Michael Nevitt², Neil A Segal², Cora E Lewis², David T Felson²

Affiliations

¹ From the Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital, Oslo, Norway; Clinical Epidemiology Research and Training Unit, and Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts; Department of Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Physical Therapy, University of Delaware, Newark, Delaware; Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany; Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, UK.B.E. Øiestad, PT, PhD, Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital; E. Quinn, MSc, Data Coordinating Center, Boston University School of Public Health; D. White, PT, ScD, MSc, Department of Physical Therapy, University of Delaware, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; F. Roemer, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, and Department of Radiology, University of Erlangen-Nuremberg; A. Guermazi, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; M. Nevitt, PhD, Department of Epidemiology and Biostatistics, University of California; N.A. Segal, MD, MS, Department of Rehabilitation Medicine, University of Kansas; C.E. Lewis, MD, MSPH, Division of Preventive Medicine, University of Alabama at Birmingham; D.T. Felson, MD, MPH, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, and Arthritis Research UK Epidemiology Unit, University of Manchester. Britt
² From the Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital, Oslo, Norway; Clinical Epidemiology Research and Training Unit, and Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts; Department of Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Physical Therapy, University of Delaware, Newark, Delaware; Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany; Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, UK.B.E. Øiestad, PT, PhD, Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital; E. Quinn, MSc, Data Coordinating Center, Boston University School of Public Health; D. White, PT, ScD, MSc, Department of Physical Therapy, University of Delaware, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; F. Roemer, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, and Department of Radiology, University of Erlangen-Nuremberg; A. Guermazi, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; M. Nevitt, PhD, Department of Epidemiology and Biostatistics, University of California; N.A. Segal, MD, MS, Department of Rehabilitation Medicine, University of Kansas; C.E. Lewis, MD, MSPH, Division of Preventive Medicine, University of Alabama at Birmingham; D.T. Felson, MD, MPH, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, and Arthritis Research UK Epidemiology Unit, University of Manchester.

PMID: 26077404
PMCID: PMC4558377
DOI: 10.3899/jrheum.150071

Multicenter Study

No Association between Daily Walking and Knee Structural Changes in People at Risk of or with Mild Knee Osteoarthritis. Prospective Data from the Multicenter Osteoarthritis Study

Britt Elin Øiestad et al. J Rheumatol. 2015 Sep.

. 2015 Sep;42(9):1685-93.

doi: 10.3899/jrheum.150071. Epub 2015 Jun 15.

Authors

Britt Elin Øiestad¹, Emily Quinn², Daniel White², Frank Roemer², Ali Guermazi², Michael Nevitt², Neil A Segal², Cora E Lewis², David T Felson²

Affiliations

¹ From the Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital, Oslo, Norway; Clinical Epidemiology Research and Training Unit, and Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts; Department of Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Physical Therapy, University of Delaware, Newark, Delaware; Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany; Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, UK.B.E. Øiestad, PT, PhD, Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital; E. Quinn, MSc, Data Coordinating Center, Boston University School of Public Health; D. White, PT, ScD, MSc, Department of Physical Therapy, University of Delaware, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; F. Roemer, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, and Department of Radiology, University of Erlangen-Nuremberg; A. Guermazi, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; M. Nevitt, PhD, Department of Epidemiology and Biostatistics, University of California; N.A. Segal, MD, MS, Department of Rehabilitation Medicine, University of Kansas; C.E. Lewis, MD, MSPH, Division of Preventive Medicine, University of Alabama at Birmingham; D.T. Felson, MD, MPH, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, and Arthritis Research UK Epidemiology Unit, University of Manchester. Britt
² From the Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital, Oslo, Norway; Clinical Epidemiology Research and Training Unit, and Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts; Department of Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Physical Therapy, University of Delaware, Newark, Delaware; Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany; Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, UK.B.E. Øiestad, PT, PhD, Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital; E. Quinn, MSc, Data Coordinating Center, Boston University School of Public Health; D. White, PT, ScD, MSc, Department of Physical Therapy, University of Delaware, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; F. Roemer, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, and Department of Radiology, University of Erlangen-Nuremberg; A. Guermazi, MD, PhD, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine; M. Nevitt, PhD, Department of Epidemiology and Biostatistics, University of California; N.A. Segal, MD, MS, Department of Rehabilitation Medicine, University of Kansas; C.E. Lewis, MD, MSPH, Division of Preventive Medicine, University of Alabama at Birmingham; D.T. Felson, MD, MPH, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, and Arthritis Research UK Epidemiology Unit, University of Manchester.

PMID: 26077404
PMCID: PMC4558377
DOI: 10.3899/jrheum.150071

Abstract

Objective: We investigated the association between objectively measured daily walking and knee structural change, defined either as radiographic worsening or as cartilage loss, in people at risk of or with knee osteoarthritis (OA).

Methods: Participants from the Multicenter Osteoarthritis Study (MOST) with Kellgren-Lawrence grades 0-2 and daily walking (measured with the StepWatch) at the 60-month visit were included. Participants had fixed-flexion, weight-bearing radiographs and knee magnetic resonance images (MRI) at 60 and 84 months. Radiographic worsening was read in both knees using the Osteoarthritis Research Society International grading, and MRI were read for 1 knee using the Whole-Organ MRI Score semiquantitative scoring. OR and 95% CI were calculated comparing those in the middle tertile against the lowest and highest tertiles of daily walking using logistic regression models and generalized estimating equations. Data on walking with moderate to vigorous intensity (min with > 100 steps/min/day) were associated to structural change using multivariate and logistic regression models.

Results: The 1179 study participants (59% women) were 67.0 years old (± 7.6), with a mean (± SD) body mass index of 29.8 kg/m(2) (± 5.3) who walked 6981 (± 2630) steps/day. After adjusting for confounders, we found no significant associations between daily walking and radiographic worsening or cartilage loss. More time spent walking at a moderate to vigorous intensity was not associated with either radiographic worsening or cartilage loss.

Conclusion: Results from the MOST study indicated no association between daily walking and structural changes over 2 years in the knees of people at risk of or with mild knee OA.

Keywords: MAGNETIC RESONANCE IMAGING; OSTEOARTHRITIS; PHYSICAL ACTIVITY; STRUCTURAL CHANGES.

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Conflict of interest statement

We have no financial conflicts of interests

Figures

**Figure 1**
Flow chart of the study participants.

**Figure 2**
The binscatter shows proportion of medial cartilage loss for tertiles of steps/day (dashed lines) adjusted for 60-month age, sex, BMI, knee injury, pain, radiographic grade, and alignment. Medial cartilage loss includes any change in the five medial subregions femur central and posterior, and tibia anterior, central, and posterior.

**Figure 3**
Proportion of medial cartilage loss given for moderate or greater intensity.

See this image and copyright information in PMC

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References

1. Lin W, Alizai H, Joseph GB, Srikhum W, Nevitt MC, Lynch JA, et al. Physical activity in relation to knee cartilage T2 progression measured with 3 T MRI over a period of 4 years: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2013;21:1558–1566. - PMC - PubMed
1. Dore DA, Winzenberg TM, Ding C, Otahal P, Pelletier JP, Martel-Pelletier J, et al. The association between objectively measured physical activity and knee structural change using MRI. Ann Rheum Dis. 2013;72:1170–1175. - PubMed
1. Jones G, Schultz MG, Dore D. Physical activity and osteoarthritis of the knee: can MRI scans shed more light on this issue? Phys Sportsmed. 2011;39:55–61. - PubMed
1. Martin KR, Kuh D, Harris TB, Guralnik JM, Coggon D, Wills AK. Body mass index, occupational activity, and leisure-time physical activity: an exploration of risk factors and modifiers for knee osteoarthritis in the 1946 British birth cohort. BMC Musculoskelet Disord. 2013;14:219. - PMC - PubMed
1. Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA. Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2013;43:515-B19. - PubMed

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[1] Lin W, Alizai H, Joseph GB, Srikhum W, Nevitt MC, Lynch JA, et al. Physical activity in relation to knee cartilage T2 progression measured with 3 T MRI over a period of 4 years: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2013;21:1558–1566. - PMC - PubMed

[2] Lin W, Alizai H, Joseph GB, Srikhum W, Nevitt MC, Lynch JA, et al. Physical activity in relation to knee cartilage T2 progression measured with 3 T MRI over a period of 4 years: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2013;21:1558–1566. - PMC - PubMed

[3] Dore DA, Winzenberg TM, Ding C, Otahal P, Pelletier JP, Martel-Pelletier J, et al. The association between objectively measured physical activity and knee structural change using MRI. Ann Rheum Dis. 2013;72:1170–1175. - PubMed

[4] Dore DA, Winzenberg TM, Ding C, Otahal P, Pelletier JP, Martel-Pelletier J, et al. The association between objectively measured physical activity and knee structural change using MRI. Ann Rheum Dis. 2013;72:1170–1175. - PubMed

[5] Jones G, Schultz MG, Dore D. Physical activity and osteoarthritis of the knee: can MRI scans shed more light on this issue? Phys Sportsmed. 2011;39:55–61. - PubMed

[6] Jones G, Schultz MG, Dore D. Physical activity and osteoarthritis of the knee: can MRI scans shed more light on this issue? Phys Sportsmed. 2011;39:55–61. - PubMed

[7] Martin KR, Kuh D, Harris TB, Guralnik JM, Coggon D, Wills AK. Body mass index, occupational activity, and leisure-time physical activity: an exploration of risk factors and modifiers for knee osteoarthritis in the 1946 British birth cohort. BMC Musculoskelet Disord. 2013;14:219. - PMC - PubMed

[8] Martin KR, Kuh D, Harris TB, Guralnik JM, Coggon D, Wills AK. Body mass index, occupational activity, and leisure-time physical activity: an exploration of risk factors and modifiers for knee osteoarthritis in the 1946 British birth cohort. BMC Musculoskelet Disord. 2013;14:219. - PMC - PubMed

[9] Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA. Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2013;43:515-B19. - PubMed

[10] Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA. Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2013;43:515-B19. - PubMed

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No Association between Daily Walking and Knee Structural Changes in People at Risk of or with Mild Knee Osteoarthritis. Prospective Data from the Multicenter Osteoarthritis Study

Affiliations

No Association between Daily Walking and Knee Structural Changes in People at Risk of or with Mild Knee Osteoarthritis. Prospective Data from the Multicenter Osteoarthritis Study

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