The Effect of Physical Activity on Disability Progression in Knee Osteoarthritis Nearly 8 million Americans are disabled as a result of their arthritis, making arthritis the major cause of disability in the US. A leading cause of arthritis-related disability is knee osteoarthritis (OA). While physical activity improves the health of persons with arthritis, it is not known if physical activity reduces disability progression, a key driver of health care costs in persons with OA. Preliminary evidence indicates that the potential benefit from physical activity to reduce disability progression in adults with arthritis may be greater in persons having less severe disease. From a public health perspective, establishing a benefit in early knee OA has important implications to appropriately target physical activity programs for adults. To comprehensively examine the epidemiology of physical activity in knee OA and the effect of higher physical activity levels on disability progression, an ancillary study to the Osteoarthritis Initiative (OAI) longitudinal study is proposed. The OAI includes the full spectrum of knee OA disease. This ancillary study includes 2280 OAI participants having or at high risk for developing symptomatic knee OA. Physical activity will be objectively measured using accelerometers to quantify activity frequency, duration, and intensity and to ascertain physical activity guideline attainment. All data in the proposed ancillary study will join the OAI public data set. The following hypotheses will be tested. 1. Persons who attain USSG (U.S. Surgeon General physical activity recommendations) guideline- recommended physical activity targets have a lower risk of disability progression over two years compared to non-attainers. The benefit of guideline attainment is stronger for persons without symptomatic knee OA compared to persons having symptoms. 2. Persons who attain USSG physical activity targets modified for arthritis have a lower risk of disability progression over two years compared to non-attainers. This benefit is stronger for persons without symptomatic knee OA compared to persons having symptoms. 3. There is a dose response relationship between physical activity levels and disability progression. Persons in the top vs. middle physical activity tertiles and middle vs. bottom tertiles will have a lower risk of disability progression over two years. Analyses will adjust for the presence of knee symptoms and radiograph evidence of disease and for potential confounders, which include knee pain intensity, age, gender, race, body mass index, cigarette smoking, economic factors, and medical comorbidities. Findings from this study will advance public health efforts to reduce disability and to improve quality of life among 21 million U.S. adults having knee OA. PHS 398/2590 (Rev. 09/04) Page 1 Continuation Format Page This study will examine if attaining recommended public health physical activity guidelines protects against disability progression in persons having or at high risk for developing symptomatic knee osteoarthritis and if guideline attainment provides greater benefit for persons without symptomatic disease. Findings from this study will advance public health efforts to reduce disability and to improve quality of life among 21 million U.S. adults having knee OA. PHS 398/2590 (Rev. 09/04) Page 1 Continuation Format Page

Public Health Relevance

This study will examine if attaining recommended public health physical activity guidelines protects against disability progression in persons having or at high risk for developing symptomatic knee osteoarthritis and if guideline attainment provides greater benefit for persons without symptomatic disease. Findings from this study will advance public health efforts to reduce disability and to improve quality of life among 21 million U.S. adults having knee OA.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR054155-04
Application #
8131667
Study Section
Neurological, Aging and Musculoskeletal Epidemiology (NAME)
Program Officer
Lester, Gayle E
Project Start
2008-09-08
Project End
2012-08-31
Budget Start
2011-09-01
Budget End
2012-08-31
Support Year
4
Fiscal Year
2011
Total Cost
$321,320
Indirect Cost
Name
Northwestern University at Chicago
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
005436803
City
Chicago
State
IL
Country
United States
Zip Code
60611
Song, Jing; Chang, Alison H; Chang, Rowland W et al. (2017) Relationship of knee pain to time in moderate and light physical activities: Data from Osteoarthritis Initiative. Semin Arthritis Rheum :
Pellegrini, Christine A; Song, Jing; Semanik, Pamela A et al. (2017) Patients Less Likely to Lose Weight Following a Knee Replacement: Results From the Osteoarthritis Initiative. J Clin Rheumatol :
White, Daniel K; Lee, Jungwha; Song, Jing et al. (2017) Potential Functional Benefit From Light Intensity Physical Activity in Knee Osteoarthritis. Am J Prev Med 53:689-696
Dunlop, Dorothy D; Song, Jing; Lee, Jungwha et al. (2017) Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms. Arthritis Care Res (Hoboken) 69:475-483
Song, Jing; Gilbert, Abigail L; Chang, Rowland W et al. (2017) Do Inactive Older Adults Who Increase Physical Activity Experience Less Disability: Evidence From the Osteoarthritis Initiative. J Clin Rheumatol 23:26-32
Pellegrini, Christine A; Song, Jing; Semanik, Pamela A et al. (2017) Patients Less Likely to Lose Weight Following a Knee Replacement: Results From the Osteoarthritis Initiative. J Clin Rheumatol 23:355-360
Lo, Grace H; McAlindon, Timothy E; Driban, Jeffrey B et al. (2016) Reply. Arthritis Rheumatol 68:1565-6
Lee, Jungwha; Chang, Rowland W; Ehrlich-Jones, Linda et al. (2015) Sedentary behavior and physical function: objective evidence from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 67:366-73
Kretzschmar, M; Lin, W; Nardo, L et al. (2015) Association of Physical Activity Measured by Accelerometer, Knee Joint Abnormalities, and Cartilage T2 Measurements Obtained From 3T Magnetic Resonance Imaging: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 67:1272-80
Dunlop, Dorothy D; Song, Jing; Arnston, Emily K et al. (2015) Sedentary time in US older adults associated with disability in activities of daily living independent of physical activity. J Phys Act Health 12:93-101

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