The association of clinical and structural knee osteoarthritis with physical activity in the middle-aged population: the NEO study

L.A Van De Stadt,M Loef,S.E.S Terpstra,R De Mutsert,M Kloppenburg,J.H.P.M Van Der Velde,M Reijnierse,F.R Rosendaal,D Schiphof

doi:10.1016/j.joca.2021.07.008

L.A Van De Stadt, M Loef + Show 7 more

Open Access

https://doi.org/10.1016/j.joca.2021.07.008

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Abstract

To investigate if knee osteoarthritis (OA) is associated with lower physical activity in the general middle-aged Dutch population, and if physical activity is associated with patient-reported outcomes in knee OA. Clinical knee OA was defined in the Netherlands Epidemiology of Obesity population using the ACR criteria, and structural knee OA on MRI. We assessed knee pain and function with the Knee Injury and Osteoarthritis Score (KOOS), health-related quality of life (HRQoL) with the Short Form-36, and physical activity (in Metabolic Equivalent of Task (MET) hours) with the Short Questionnaire to Assess Health-enhancing physical activity. We analysed the associations of knee OA with physical activity, and of physical activity with knee pain, function, and HRQoL in knee OA with linear regression adjusted for potential confounders. Clinical knee OA was present in 14% of 6,212 participants, (mean age 56 years, mean BMI 27kg/m2, 55% women, 24% having any comorbidity) and structural knee OA in 12%. Clinical knee OA was associated with 9.60 (95% CI 3.70; 15.50) MET hours per week more physical activity, vs no clinical knee OA. Structural knee OA was associated with 3.97 (-7.82; 15.76) MET hours per week more physical activity, vs no structural knee OA. In clinical knee OA, physical activity was not associated with knee pain, function or HRQoL. Knee OA was not associated with lower physical activity, and in knee OA physical activity was not associated with patient-reported outcomes. Future research should indicate the optimal treatment advice regarding physical activity for individual knee OA patients.

Highlights

Rheumatic musculoskeletal disorders (RMDs) are among the leading causes of disability in the middle-aged population
As lack of physical activity has shown to be associated with wide-ranging adverse health outcomes3e6, we investigated the association of physical activity with patient-reported outcomes such as knee pain, function and healthrelated quality of life (HRQoL) in individuals with knee OA
To account for possible information bias commonly associated with self-reported physical activity measures, we investigated the association between clinical knee OA and physical activity measured by an accelerometer

Summary

Introduction

Rheumatic musculoskeletal disorders (RMDs) are among the leading causes of disability in the middle-aged population. One of the most common RMDs is osteoarthritis (OA), which affected approximately 300 million people globally in 2017, and its prevalence is expected to keep rising[1]. No disease-modifying treatment is available for OA, which often leads to chronic use of analgesics to suppress symptoms, until eventually joint replacement surgery is performed in end-stage disease[2]. As pain, reduced quality of life and functional complaints are among the most prevalent knee OA symptoms and can impede physical activity[1], insight in lifestyle factors that reduce pain, increase functional performance and perhaps even slow down progression is highly warranted. S.E.S. Terpstra et al / Osteoarthritis and Cartilage 29 (2021) 1507e1514 performance, cardiovascular events, and increased mortality3e6

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