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Association of Pain and Steps Per Day in Persons With Mild‐to‐Moderate, Symptomatic Knee Osteoarthritis: A Mixed‐Effects Models Analysis of Multiple Measurements Over Three Years
Author(s) -
Brisson Nicholas M.,
Gatti Anthony A.,
Maly Monica R.
Publication year - 2020
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23842
Subject(s) - osteoarthritis , medicine , knee pain , observational study , physical therapy , body mass index , physical activity , knee joint , surgery , alternative medicine , pathology
Objective Pain is a consistently reported barrier to physical activity by persons with knee osteoarthritis ( OA ). Nonetheless, few studies of knee OA have investigated the association of pain with daily walking levels. The current study assessed the relationship of 2 distinct measures of knee pain with objectively measured physical activity in adults with knee OA . Methods This was a longitudinal, observational investigation of 59 individuals (48 women; mean ± SD age 61.1 ± 6.4 years, mean ± SD body mass index 28.1 ± 5.6 kg/m 2 ) with clinical knee OA . Data were collected every 3 months for up to 3 years. Physical activity was characterized as the average steps per day taken over at least 3 days, mea‐sured by accelerometry. Pain was measured using 2 patient‐administered questionnaires: the pain subscale of the Knee Injury and Osteoarthritis Outcome Score ( KOOS ‐pain) and the P4 pain scale (P4‐pain). Mixed‐effects models determined the association between pain and physical activity levels (over covariates) among adults with knee OA (α = 0.05). Results All covariates (age [β = –3.65, P < 0.001], body mass index [β = –3.06, P < 0.001], season [spring/fall β = –6.91, P = 0.002; winter β = –14.92, P < 0.001]) were predictors of physical activity. Neither the inverted KOOS ‐pain (β = 0.04, P = 0.717) nor P4‐pain (β = –0.37, P = 0.264) was associated with physical activity. Conclusion Knee pain is not associated with daily walking levels in persons with mild‐to‐moderate, symptomatic knee OA . While pain management remains an important target of interventions, strategies to increase steps per day in this population should focus on overcoming potentially more crucial barriers to activity participation.