The Association of Diabetes With Knee Pain Locations, Pain While Walking, and Walking Speed: Data From the Osteoarthritis Initiative

Phys Ther. 2020 Aug 4;pzaa144. doi: 10.1093/ptj/pzaa144. Online ahead of print.


Objective: Osteoarthritis (OA) and diabetes mellitus (DM) often coexist and may result in negative outcomes. DM may affect pain and walking speed in people with knee OA; however, the impact of DM on OA is understudied. The purpose of this study was to investigate the association between diabetes and knee pain locations, pain severity while walking, and walking speed in people with knee OA.

Methods: A cross-sectional analysis was used. Data from 1790 individuals from the Osteoarthritis Initiative (mean age = 69 [±8.7] y) with knee pain were included and grouped into knee OA and diabetes (n = 236) or knee OA only (n = 1554). Knee pain locations were categorized as no pain, localized pain, regional pain, or diffuse pain. Knee pain during a 20 m walk test was categorized as no pain, mild, moderate, or severe knee pain. Walking speed was measured using the 20-m walk test. Multinomial and linear regression analyses were performed.

Results: Diabetes was associated with regional knee pain (odds ratio [OR] = 1.77, 95% CI = 1.01 to 3.11). Diabetes was associated with only moderate (OR = 1.78, 95% CI = 1.02 to 3.10), and severe pain while walking (OR = 2.52, 95% CI = 1.01 to 6.28). Diabetes was associated with decreased walking speed (B = -0.064; 95% CI = -0.09 to -0.03).

Conclusions: Diabetes was associated with regional knee pain but not with localized or diffuse knee pain and was associated with moderate to severe knee pain while walking and slower walking speed in people with knee OA.

Impact: Clinicians may use knee pain map for examining knee pain locations for people with diabetes and knee OA. knee pain during walk and walking speed should be screened for people with knee OA and diabetes because of diabetes influence on theses parameters in this population.

Keywords: Elderly; Gait speed; Knee pain map.