Could Activity Modifications Indicate Physical Decline Among Adults With Symptomatic Knee Osteoarthritis?

Am J Phys Med Rehabil. 2018 Feb;97(2):96-103. doi: 10.1097/PHM.0000000000000802.


Objectives: Mobility activity modifications indicate early functional losses that act as precursors to future declines among community-dwelling older adults. However, there is scarce evidence on whether activity modifications indicate poorer physical health among adults with symptomatic osteoarthritis, a major cause of disability. Our purpose was to investigate whether patient-reported mobility activity modifications indicated poorer physical health among adults with symptomatic knee osteoarthritis.

Design: Secondary cross-sectional analysis of randomized trial data was performed. Preclinical Disability Questionnaire was used to group participants into the following three categories: difficulty, modified, and no difficulty walking/stair climbing. Kruskal Wallis and χ tests were used to compare clinical factors across groups.

Results: Among 121 participants (median age = 60 yrs; 73% female; 60% white), less than 10% had modified walking/stair climbing. Compared with those with no walking difficulty, participants with modified walking had significantly less balance (P = 0.01) and global health (P = 0.01) as well as greater knee pain (P = 0.05) and physical disability (P = 0.04). Those with modified stair climbing had significantly smaller walking distances (P = 0.03) compared with those with no difficulty stair climbing.

Conclusions: Activity modifications may signal early impairments in physical health among people with symptomatic knee osteoarthritis. If confirmed, patient-reported activity modifications may enhance symptom evaluation in osteoarthritis and enable a better understanding of the disablement process.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Disability Evaluation
  • Exercise / physiology*
  • Female
  • Humans
  • Knee Joint / physiopathology
  • Male
  • Middle Aged
  • Mobility Limitation*
  • Osteoarthritis, Knee / physiopathology*
  • Osteoarthritis, Knee / therapy
  • Physical Therapy Modalities
  • Postural Balance / physiology
  • Randomized Controlled Trials as Topic
  • Range of Motion, Articular / physiology
  • Single-Blind Method
  • Statistics, Nonparametric
  • Tai Ji / methods
  • Walking / physiology