Could Activity Modifications Indicate Physical Decline Among Adults With Symptomatic Knee Osteoarthritis?
Augustine C Lee, Rina M Bloch, William F Harvey and 4 others
PMID 28763325WHAT IT FOUND
Adults with knee OA who changed how or how often they walked, without feeling limited, had more pain, poorer function, worse global health and poorer balance than those who changed nothing.
People who changed stair climbing without feeling limited also walked less in 6 minutes.
Key findings
01Participants who modified walking but did not report walking difficulty had poorer balance and global health, and more pain, physical disability and stiffness, than participants with no walking difficulty.
02Participants who modified stair-climbing but did not report stair-climbing difficulty walked a shorter 6-minute distance than participants with no stair-climbing difficulty.
03Only 9 of 121 participants with walking data were classified as modifying walking without reported difficulty, and only 9 of 106 participants with stair-climbing data were classified as modifying stair-climbing without reported difficulty.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The modified groups were very small: only 9 of 121 participants with walking data and 9 of 106 with stair-climbing data were classified as modifying that activity. The analysis was cross-sectional, so it cannot show that activity modifications caused physical decline or predicted future decline. The analyses were hypothesis-generating and not adjusted for multiple comparisons, so some positive findings need confirmation. Participants came from a knee OA clinical trial and were required to be symptomatic, radiographically verified, and able to walk without an assistive device, so they may not represent all people with knee OA. The modification questionnaire used yes/no questions and did not ask whether the modifications were due to knee OA. The Tai Chi and Physical Therapy groups were combined because their trial outcomes were similar, so this analysis does not show how either treatment affected mobility modification status. Several stair-climbing differences were only marginally significant, so they should not be treated as firm findings.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that asking about walking or stair-climbing modifications is a proven way to detect early decline in knee OA. The study was cross-sectional, only 9 of 121 walking-data participants and 9 of 106 stair-climbing-data participants were in the modified groups, and the stair-climbing differences were described as marginally significant.