High Risk Of Knee Osteoarthritis Research Articles

Potential Functional Benefit From Light Intensity Physical Activity in Knee Osteoarthritis

Knee pain may preclude participation in higher intensity physical activity in people with knee osteoarthritis and benefits of light activity are unclear. The effect of replacing sedentary time with light intensity activity on incident functional limitation 2 years later was investigated. Included were people with or at high risk of knee osteoarthritis without baseline functional limitation using data from the Osteoarthritis Initiative collected between August 2008 and July 2010. Data were analyzed between May 2016 and August 2016 for time in sedentary, light, and moderate to vigorous physical activity from accelerometer monitoring. Incident functional limitation was defined as (1) slow gait speed <1.0 meters/second during a 20-meter walk, (2) Western Ontario and McMasters University Osteoarthritis Index physical function ≥28, or (3) Short Form 12 Physical Component scale <40. Inclusion criteria were met by 1,873 people (mean age=65.0 [SD=9.0] years, mean BMI=28.4 [SD=4.7] kg/m2). Replacing 60 minutes/day of sedentary time with 60 minutes/day of light activity was associated with a 17% reduced risk for incident slow gait speed 2 years later (Hazard Ratio=0.83, 95% CI=0.70, 0.99) after adjustment. Approximately 5 minutes/day of moderate to vigorous physical activity would be necessary to receive the equivalent benefit of 60 minutes/day of light activity. Effects in secondary patient-reported outcomes did not reach statistical significance. Replacing sedentary time with light activity may reduce the risk of performance-based functional limitation. As expected, moderate to vigorous physical activity rather than light provided stronger risk reduction. When moderate to vigorous physical activity is not an option, pursuing light activity may be a beneficial alternative to being sedentary.

Dietary magnesium intake and fracture risk: data from a large prospective study.

Research considering the relationship between dietary Mg and osteoporosis as well as fractures are sparse and conflicting. We therefore aimed to investigate Mg intake and the onset of fractures in a large cohort of American men and women involved in the Osteoarthritis Initiative over a follow-up period of 8 years. Dietary Mg intake (including that derived from supplementation) was evaluated through a FFQ at baseline and categorised using sex-specific quintiles (Q); osteoporotic fractures were evaluated through self-reported history. Overall, 3765 participants (1577 men; 2071 women) with a mean age of 60·6 (sd 9·1) years were included. During follow-up, 560 individuals (198 men and 368 women) developed a new fracture. After adjusting for fourteen potential confounders at baseline and taking those with lower Mg intake as reference (Q1), men (hazard ratio (HR) 0·47; 95 % CI 0·21, 1·00, P=0·05) and women (HR 0·38; 95 % CI 0·17, 0·82, P=0·01) in the highest quintile reported a significantly lower risk for fracture. Women meeting the recommended Mg intake were at a 27 % decreased risk for future fractures. In conclusion, higher dietary Mg intake has a protective effect on future osteoporotic fractures, especially in women with a high risk for knee osteoarthritis. Those women meeting the recommended Mg intake appear to be at a lower risk for fractures.

Relation of pain sensitization to development of constant, persistent pain in knee osteoarthritis: The multicenter osteoarthritis study

Purpose: Patients with knee osteoarthritis (OA) often start with acute intermittent, activity-related pain, which evolves to additionally experiencing chronic, persistent pain. Why this transition happens is not known. It is possible that peripheral and central sensitization, which are associated with knee pain severity in knee OA, contributes to the transition from solely acute intermittent to chronic, persistent pain. We assessed whether a marker of sensitization, pressure pain threshold (PPT), was associated with developing chronic, persistent pain over time in a large cohort of older adults with or at risk of knee OA. Methods: The Multicenter Osteoarthritis (MOST) Study is a NIH-funded longitudinal cohort of persons with or at high risk of knee OA. Subjects had a standardized somatosensory evaluation of mechanical pressure pain thresholds (PPT) at the wrist and patella and completed pain questionnaires at baseline and two years later. PPT was assessed with an algometer (1 cm2 tip, 0.5 Kg/sec) as the point at which the subject felt the pressure first changed to slight pain. We averaged of 3 PPT trials at each anatomic site. Lower PPT indicates more sensitization/pain sensitivity; at a site of disease (e.g., knee), it indicates peripheral sensitization, and at a site without disease (e.g., wrist), it indicates central sensitization. The Intermittent and Constant OA Pain (ICOAP) instrument assesses presence and severity of intermittent and constant pain, and for intermittent pain, its frequency. Using the knee-specific ICOAP, pain patterns were defined as: 1) no intermittent or constant pain; 2) intermittent pain only (of at least mild severity occurring at least sometimes); and 3) constant pain (of at least mild severity) with or without intermittent pain. Among subjects with either no pain or intermittent pain only at baseline, we evaluated the relation of baseline PPT to incidence of constant pain using logistic regression. We evaluated baseline PPT as a continuous measure, and also evaluated PPT as tertiles to evaluate for a dose-response and threshold effect. All analyses were adjusted for age, sex, BMI, depressive symptoms, catastrophizing, widespread pain, and clinic site. Results: There were 1951 subjects included (mean age 68, 60% female, mean BMI 31), of whom ∼8% developed constant pain over two years. A higher level of sensitization, as reflected by lower PPT, was associated with higher risk of developing incident constant pain [knee PPT: OR 1.14 (95% CI 1.01–1.27, p = 0.03); wrist PPT: OR 1.12 (95% CI 0.97–1.33, p = 0.1)]. Figure 1 illustrates the adjusted ORs for risk of incident constant pain by PPT tertiles for the knee (p = 0.05) and the wrist (p = 0.02). Because there appeared to be a threshold effect for the wrist PPT, we evaluated the lowest PPT tertile with the higher two tertiles. The lowest knee PPT tertile, reflecting greater peripheral sensitization, was associated with a higher risk of developing incident constant pain compared with the two higher PPT tertiles (less sensitization) [OR: 1.57 (95% CI 1.00–2.48, p = 0.05)]. Similarly, a higher level of central sensitization as measured by the lowest wrist PPT tertile was also associated with a higher risk of incident constant pain [OR: 2.01 (95% CI 1.15–3.51, p = 0.01)]. Conclusions: Higher levels of peripheral and central sensitization were associated with greater risk of evolution or progression of the pain pattern from no or intermittent pain to constant pain over time. These findings support the hypothesis that sensitization plays an important role in changing a patient’s pattern and severity of OA-related pain. These findings have implications for understanding the transition from acute to chronic pain.

Physical activity and worsening of radiographic findings in persons with or at higher risk for knee osteoarthritis

Physical activity and worsening of radiographic findings in persons with or at higher risk for knee osteoarthritis

Video-analysis of the effect of different types of adapted shoes on knee adduction moment

Background. The effect of different footwear profiles on knee adduction moment have not been fully studied.&#x0D; Methods. Fifteen healthy volunteer subjects, age 25.3 (±2.73), undertook a series of gait laboratory trials with adapted shoes. Kinematic and kinetic data were collect using 16 Oqus 3+ cameras and the walking speed was controlled using timing gates. High street shoes were adapted to include five different heel heights (varying from a 1.5 cm to 5.5 cm heels), two heel profile conditions (curved and semi-curved heels), three varying apex angles (10, 15, and 20 degrees), and barefoot and 3CR footwear conditions. The baseline shoe had no heel curve, a heel height of 3.5cm, an apex position of 62.5% of the shoe length, an apex angle of 15 deg, and a rigid forepart of the shoe.&#x0D; Results. The shoe with 5.5 cm heel height significantly increased the mean knee adduction moment during 50%–100% of the stance phase compared to the 1.5 cm heel (p = 0.008). The high heel shoe also significantly increased knee adduction impulse (area under the curve) versus the 1.5, 2.5, and 3.5 cm heels, and the 10° toe angle and barefoot condition. Ten degrees of toe angle reduced mean knee adduction moment during 0%–50% of the stance phase versus 20° and significantly reduced mean knee adduction moment during the late stance phase versus 15° and 20° toe angle footwear conditions. Walking with the curved heel for the healthy subjects increased mean knee adduction moment during 0%–50% of the stance phase compared to the heel without curvature (p &lt; 0.0009).&#x0D; Conclusion. Further study is required to investigate those changes in patients with high risk of knee osteoarthritis.

Risk prediction model for knee pain in the Nottingham community: a Bayesian modelling approach

BackgroundTwenty-five percent of the British population over the age of 50 years experiences knee pain. Knee pain can limit physical ability and cause distress and bears significant socioeconomic costs. The objectives of this study were to develop and validate the first risk prediction model for incident knee pain in the Nottingham community and validate this internally within the Nottingham cohort and externally within the Osteoarthritis Initiative (OAI) cohort.MethodsA total of 1822 participants from the Nottingham community who were at risk for knee pain were followed for 12 years. Of this cohort, two-thirds (n = 1203) were used to develop the risk prediction model, and one-third (n = 619) were used to validate the model. Incident knee pain was defined as pain on most days for at least 1 month in the past 12 months. Predictors were age, sex, body mass index, pain elsewhere, prior knee injury and knee alignment. A Bayesian logistic regression model was used to determine the probability of an OR >1. The Hosmer-Lemeshow χ2 statistic (HLS) was used for calibration, and ROC curve analysis was used for discrimination. The OAI cohort from the United States was also used to examine the performance of the model.ResultsA risk prediction model for knee pain incidence was developed using a Bayesian approach. The model had good calibration, with an HLS of 7.17 (p = 0.52) and moderate discriminative ability (ROC 0.70) in the community. Individual scenarios are given using the model. However, the model had poor calibration (HLS 5866.28, p < 0.01) and poor discriminative ability (ROC 0.54) in the OAI cohort.ConclusionsTo our knowledge, this is the first risk prediction model for knee pain, regardless of underlying structural changes of knee osteoarthritis, in the community using a Bayesian modelling approach. The model appears to work well in a community-based population but not in individuals with a higher risk for knee osteoarthritis, and it may provide a convenient tool for use in primary care to predict the risk of knee pain in the general population.

Brief Report: Partial- and Full-Thickness Focal Cartilage Defects Contribute Equally to Development of New Cartilage Damage in Knee Osteoarthritis: The Multicenter Osteoarthritis Study.

To determine the risk of incident cartilage damage at follow-up in subregions that are undamaged at baseline, by comparing tibiofemoral joint compartments with a baseline focal partial-thickness or full-thickness cartilage defect against compartments without any baseline cartilage damage, in knees with and those without radiographic osteoarthritis (OA). We included participants in the Multicenter Osteoarthritis Study for whom there were semiquantitative magnetic resonance imaging readings at baseline and at 30 months. We estimated the risk of incident cartilage defects developing in tibiofemoral compartments with prevalent partial-thickness and full-thickness cartilage defects in only one subregion within the compartment, using tibiofemoral compartments with no baseline cartilage defects as a referent. Logistic regression with generalized estimating equations was used for all analyses, with adjustments for confounders. A total of 374 compartments (359 knees) were included, and 140 knees (39%) had radiographic OA. Compared to compartments with no baseline cartilage defects, those with partial-thickness (adjusted odds ratio 1.62 [95% confidence interval 1.06-2.47]) and full-thickness (adjusted odds ratio 1.92 [95% confidence interval 1.00-3.66]) cartilage defects in a subregion had a higher risk of incident cartilage defects in other subregions in the same compartment. Prevalent focal cartilage defects, regardless of defect depth, in a single subregion within a tibiofemoral joint compartment increase the risk of developing new cartilage damage in other subregions of the same compartment for middle-aged to elderly persons with or at high risk of knee OA.

Knee tissue lesions and prediction of incident knee osteoarthritis over 7 years in a cohort of persons at higher risk.

Among high risk individuals, whether knee lesions in tissues involved in osteoarthritis (OA) can improve prediction of knee OA is unclear. We hypothesized that models predicting (1) incident osteophytes and (2) incident osteophytes and joint space narrowing can be improved by including symptoms or function, and further improved by lesion status. In Osteoarthritis Initiative (OAI) participants with normal knee X-rays, we assessed cartilage damage, bone marrow lesions (BMLs), and menisci. Cox proportional hazards models were used to develop risk prediction models for risk of each outcome. Nested models (increasingly larger baseline covariable sets) were compared using likelihood ratio tests and Schwarz Bayesian Information Criterion (SBC). Model discrimination used receiver operating characteristic (ROC) curves and area under the curve (AUC). In 841 participants [age 59.6, body mass index (BMI) 26.7, 55.9% women] over up to 7 years follow-up, each larger set improved prediction (+hand OA, injury, surgery, activities;+symptoms/function). Prediction was further improved by including cartilage damage both compartments, BMLs both compartments, meniscal tear, meniscal extrusion, sum of lesion types, number of subregions with cartilage damage, number of subregions with BMLs, and (concurrently) subregion number with cartilage damage, subregion number with BMLs, and meniscal tear. AUCs were ≥0.80 for both outcomes for number of subregions with cartilage damage and the combined model. Among persons at higher risk for knee OA with normal X-rays, MRI tissue lesions improved prediction of mild as well as moderate disease. These findings support that disease onset is likely occurring during the "high-risk" period and encourage a reorientation of approach.

Multiple Nonspecific Sites of Joint Pain Outside the Knees Develop in Persons With Knee Pain.

Many persons with knee pain have joint pain outside the knee, but despite the impact and high frequency of this pain, its distribution and causes have not been studied. We undertook this study to test the hypothesis of those studying gait abnormalities who have suggested that knee pain causes pain in adjacent joints but that pain adaptation strategies are highly individualized. We studied persons ages 50-79 years with or at high risk of knee osteoarthritis who were recruited from 2 community-based cohorts, the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative, and we followed them up for 5-7 years. We excluded those with knee pain at baseline and compared those who had developed knee pain at the first follow-up examination (the index visit) with those who had not. We examined pain on most days at joint regions outside the knee in examinations after the index visit. Logistic regression analyses examined the risk of joint-specific pain adjusted for age, sex, body mass index, and symptoms of depression, and we performed sensitivity analyses excluding those with widespread pain. In the combined cohorts, 693 persons had knee pain at the index visit and 2,793 did not. A total of 79.6% of those with bilateral knee pain and 63.8% of those with unilateral knee pain had pain during follow-up in a joint region outside the knee, compared with 49.9% of those without knee pain. There was an increased risk of pain at most extremity joint sites, without a predilection for specific sites. Results were unchanged when those with widespread pain were excluded. Persons with chronic knee pain are at increased risk of pain in multiple joints in no specific pattern.

Do Inactive Older Adults Who Increase Physical Activity Experience Less Disability: Evidence From the Osteoarthritis Initiative.

Physical inactivity is a leading risk factor for developing disability. Although randomized clinical trials have demonstrated improving physical activity can reduce this risk in older adults with arthritis, these studies did not specifically evaluate inactive adults. The aim of this study was to evaluate the relationship of changes in physical activity with disability changes among initially inactive adults with or at high risk of knee osteoarthritis from Osteoarthritis Initiative. Inactive persons were identified at baseline based on the US Department of Health and Human Services classification (no [zero] 10-minute session of moderate-to-vigorous [MV] activity over 1 week) from objective accelerometer monitoring. Two years later, physical activity change status was classified as follows: (1) met Federal physical activity guidelines (≥150 MV minutes/week acquired in bouts ≥10 minutes), (2) insufficiently increased activity (some but <150 MV bout minutes/week), or (3) remained inactive. Disability at baseline and 2 years was assessed by Late Life Disability Instrument limitation and frequency scores. Multiple regression evaluated the relationship of physical activity change status with baseline-to-2-year changes in disability scores adjusting for socioeconomics, health factors, and baseline disability score. Increased physical activity showed a graded relationship with improved disability scores in Late Life Disability Instrument limitation (P < 0.001) and frequency scores (P = 0.027). While increasing MV activity to guideline levels showed the greatest reduction, even insufficiently increased physical activity was related to reduced disability. Findings support advice to increase MV physical activity to reduce disability among inactive adults with or at high risk of knee osteoarthritis, even when guidelines are not met.

Factors associated with meniscal body extrusion on knee MRI in overweight and obese women.

To determine factors associated with higher degree of meniscal body extrusion in overweight and obese women at high risk of knee osteoarthritis (OA). We used baseline data of the PRevention of knee Osteoarthritis in Overweight Females (PROOF) study, Netherlands, comprising overweight or obese women aged 50-60 years, free of clinical knee OA. All subjects completed a questionnaire on knee complaints and physical activity, underwent physical examination, radiography, and 1.5T magnetic resonance imaging (MRI) of both knees. Using the mid-coronal MRI slice, one blinded observer measured tibial plateau width and meniscal body extrusion of both menisci in both knees. The association between baseline factors and meniscal extrusion, were analyzed with a random effects regression model. In addition, we used a fixed effect regression model for evaluation of knee-specific factors. Mean age of the included women (n=395) was 55.7 years and mean body mass index (BMI) 32.4kg/m2. Of all knees, 23% had an absolute medial meniscus body extrusion ≥3.0mm and 4% had lateral meniscus body extrusion ≥3.0mm. In the multivariable model, the medial meniscus extrusion was increased by 0.44mm (95% confidence interval [CI] 0.11, 0.77) when a medial meniscus tear was present, by 0.20mm per 5kg/m2 (95% CI 0.05, 0.35) increase in BMI and by 0.25 in the presence of mild knee symptoms (95% CI 0.05 to 0.44). Kellgren-Lawrence (KL) grade ≥1 and tibia width were associated with increased both medial and lateral extrusion. In women, ipsilateral meniscus tear and high BMI are factors associated with medial meniscus body extrusion.

The Association of Vibratory Perception and Muscle Strength With the Incidence and Worsening of Knee Instability: The Multicenter Osteoarthritis Study.

To examine neuromuscular factors that predict the incidence and progression of knee instability symptoms in older adults with or at high risk of knee osteoarthritis (OA). At the 60-month clinic visit, participants in the Multicenter Osteoarthritis Study underwent evaluation of quantitative vibratory sense at the knee and isokinetic quadriceps muscle strength. At this 60-month visit, participants were also asked about knee buckling and sensations of knee shifting or slipping without buckling in the past 3 months and then were asked the same questions at the 72- and 84-month follow-up visits. We performed a person-based analysis using Poisson regression analysis with robust error variance to estimate adjusted relative risks (RRs) for the association of vibratory sense and muscle strength with the incidence and worsening of knee slipping/shifting, buckling, and overall knee instability symptoms (either buckling or knee shifting/slipping), with adjustment for relevant confounders. A total of 1,803 participants (61% women) were included. Approximately one-third of the participants reported incident or worsening of instability symptoms over the study period. After adjustment for relevant confounders, better vibratory acuity (adjusted RR 0.78, 95% confidence interval [95% CI] 0.56-1.09), P = 0.020 for trend) and greater quadriceps strength (adjusted RR 0.53, 95% CI 0.38-0.75, P < 0.001) protected against incident knee instability symptoms. Greater quadriceps strength (adjusted RR 0.73, 95% CI 0.58-0.92, P = 0.008) also protected against worsening of knee instability symptoms. Vibratory acuity and quadriceps muscle strength are important predictors of the incidence and worsening of knee instability over 2 years. These neuromuscular factors are potentially modifiable and should be considered in interventional studies of instability in persons with or at risk of knee OA.

Prediction of incident radiographic disease and function outcome in a cohort of persons at higher risk for knee osteoarthritis

Prediction of incident radiographic disease and function outcome in a cohort of persons at higher risk for knee osteoarthritis

Simple Scoring System and Artificial Neural Network for Knee Osteoarthritis Risk Prediction: A Cross-Sectional Study.

BackgroundKnee osteoarthritis (OA) is the most common joint disease of adults worldwide. Since the treatments for advanced radiographic knee OA are limited, clinicians face a significant challenge of identifying patients who are at high risk of OA in a timely and appropriate way. Therefore, we developed a simple self-assessment scoring system and an improved artificial neural network (ANN) model for knee OA.MethodsThe Fifth Korea National Health and Nutrition Examination Surveys (KNHANES V-1) data were used to develop a scoring system and ANN for radiographic knee OA. A logistic regression analysis was used to determine the predictors of the scoring system. The ANN was constructed using 1777 participants and validated internally on 888 participants in the KNHANES V-1. The predictors of the scoring system were selected as the inputs of the ANN. External validation was performed using 4731 participants in the Osteoarthritis Initiative (OAI). Area under the curve (AUC) of the receiver operating characteristic was calculated to compare the prediction models.ResultsThe scoring system and ANN were built using the independent predictors including sex, age, body mass index, educational status, hypertension, moderate physical activity, and knee pain. In the internal validation, both scoring system and ANN predicted radiographic knee OA (AUC 0.73 versus 0.81, p<0.001) and symptomatic knee OA (AUC 0.88 versus 0.94, p<0.001) with good discriminative ability. In the external validation, both scoring system and ANN showed lower discriminative ability in predicting radiographic knee OA (AUC 0.62 versus 0.67, p<0.001) and symptomatic knee OA (AUC 0.70 versus 0.76, p<0.001).ConclusionsThe self-assessment scoring system may be useful for identifying the adults at high risk for knee OA. The performance of the scoring system is improved significantly by the ANN. We provided an ANN calculator to simply predict the knee OA risk.

Changes in patellofemoral and tibiofemoral joint cartilage damage and bone marrow lesions over 7 years: the Multicenter Osteoarthritis Study

To investigate changes in cartilage damage and bone marrow lesions (BMLs) on MRI in the patellofemoral and tibiofemoral joints (TFJs) over 7 years. The Multicenter Osteoarthritis (MOST) Study is a cohort study of persons aged 50-79 years at baseline with or at high risk for knee osteoarthritis (OA). Knees were eligible for the current study if they had knee MRI (1.0T) assessed for cartilage damage and BMLs at the baseline and 84-month visits. Knees were categorized as having MRI-detected structural damage (cartilage and BMLs) isolated to the patellofemoral joint (PFJ), isolated to the TFJ, mixed or no damage at baseline and 84-months. We determined the changes in PFJ and TFJ structural damage over 7 years and used logistic regression to assess the relation of baseline compartment distribution to incident isolated PFJ, isolated TFJ and mixed damage. Among 339 knees that had full-thickness cartilage loss isolated to the PFJ or TFJ at baseline, only 68 (20.1%) developed full-thickness cartilage loss in the other compartment while 271 (79.9%) continued to only have the initial compartment affected. Compared to knees without full-thickness cartilage damage (n=582), those with isolated TFJ and PFJ full-thickness cartilage damage had 2.7 (1.5, 4.9) and 5.8 (3.6, 9.6) times the odds of incident mixed full-thickness cartilage damage, respectively. Similar results were seen when using other definitions of MRI-defined structural damage. Most knees with structural damage at baseline do not develop it in the other compartment. Knees that develop mixed structural damage are more likely to start with it isolated to the PFJ.

Clinical significance of worsening versus stable preradiographic MRI lesions in a cohort study of persons at higher risk for knee osteoarthritis

BackgroundWhether preradiographic lesions in knees at risk for osteoarthritis are incidental versus disease is unclear. We hypothesised, in persons without but at higher risk for knee osteoarthritis, that: 12–48 month...

Association of urinary biomarker COLL2-1NO2 with incident clinical and radiographic knee OA in overweight and obese women

To investigate the association between urinary biomarker Coll2-1NO2 (uColl2-1NO2) and incident knee OA after 2.5 years follow-up in middle-aged overweight and obese women at high risk for knee osteoarthritis (OA). Data were used from PROOF, a randomized controlled trial with 2.5 years follow-up evaluating the preventive effects of a diet and exercise program and oral glucosamine sulphate (double blind and placebo controlled), on development of incident knee OA in women with body mass index ≥ 27 kg/m(2) without signs of knee OA at baseline. Baseline and 2.5 years uColl2-1NO2 concentrations were assessed with enzyme-linked immunosorbent assay (ELISA). Primary outcome measure was incidence of knee OA in one or both knees, defined as incidence of either Kellgren & Lawrence grade ≥2, joint space narrowing of ≥1.0 mm or knee OA according to the combined clinical and radiographic ACR-criteria. We used binary logistic regression for the association analyses. 254 women were available for analyses. At 2.5 years follow-up, incident knee OA was present in 72 of 254 women (28.3%). An inversed association was found between baseline uColl2-1NO2 and incident knee OA at 2.5 years (OR 0.74, 95% CI 0.55-0.99). The concentration at 2.5 years and the change in concentration over 2.5 years did not show significant associations with the outcome. In overweight and obese middle-aged women, not higher but lower baseline uColl2-1NO2 concentration was significantly associated with an increased risk for incident knee OA. This interesting but counterintuitive outcome makes further validation of this biomarker warranted.

Significance of changing vs. stable pre-radiographic MRI lesions in persons at higher risk for knee osteoarthritis

Significance of changing vs. stable pre-radiographic MRI lesions in persons at higher risk for knee osteoarthritis

Lower Extremity Jogging Mechanics in Young Female with Mild &lt;i&gt;Hallux valgus&lt;/i&gt;

The purpose of this current study was to measure the knee joint angle and plantar pressure distribution between hallux valgus group and normal group under jogging condition. To reveal relationship of plantar pressure distribution and knee joint angle. Investigated that lower extremity mechanics of jogging in young female with mild hallux valgus. Sixteen young, healthy females volunteered to take part in this study. Kinematic data from a three-dimensional motion analysis system and plantar pressure distribution from Pedar-X system were collected to describe lower extremity mechanics while hallux valgus subjects jogging at a natural speed. The results found that knee joint angle of hallux valgus in frontal and transverse plane was obviously different under jogging condition. In frontal plane, the initial state of adduction angle (control group (CO) = 1.73 °, hallux valgus group (HV) = 8.33 °) of two group was markedly different at the beginning of the support (0-10%). During jogging gait cycle, knee abduction angle peak of normal group was 8.46°, and knee adduction angle peak of hallux valgus group was 8.61°. In the transverse plane, knee external rotation angle in the initial state of normal group was 21.93° while knee external rotation angle of hallux valgus was 4.89°. The results of plantar pressure found that bearing pressure regions was offshore in hallux valgus group. These changes would affect the movement of knee joint, and it suggested that hallux valgus group have higher risk for knee osteoarthritis. These results also suggested that hallux valgus deformity has influence on knee joint. We cannot be ignored in the process of the research and therapeutic with hallux valgus.

Accelerometer-monitored sedentary behavior and observed physical function loss.

We examined whether objectively measured sedentary behavior is related to subsequent functional loss among community-dwelling adults with or at high risk for knee osteoarthritis. We analyzed longitudinal data (2008-2012) from 1659 Osteoarthritis Initiative participants aged 49 to 83 years in 4 cities. Baseline sedentary time was assessed by accelerometer monitoring. Functional loss (gait speed and chair stand testing) was regressed on baseline sedentary time and covariates (baseline function; socioeconomics [age, gender, race/ethnicity, income, education], health factors [obesity, depression, comorbidities, knee symptoms, knee osteoarthritis severity, prior knee injury, other lower extremity pain, smoking], and moderate-to-vigorous activity). This cohort spent almost two thirds of their waking hours (average=9.8 h) in sedentary behaviors. Sedentary time was significantly positively associated with subsequent functional loss in both gait speed (-1.66 ft/min decrease per 10% increment sedentary percentage waking hours) and chair stand rate (-0.75 repetitions/min decrease), controlling for covariates. Being less sedentary was related to less future decline in function, independent of time spent in moderate-to-vigorous activity. Both limiting sedentary activities and promoting physical activity in adults with knee osteoarthritis may be important in maintaining function.