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Home/Large Joints and Extremities/Does Intensity of Walking Affect Knee Osteoarthritis?
Large Joints and Extremities

Does Intensity of Walking Affect Knee Osteoarthritis?

July 25, 2018 2 min read Premium comments

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Does Intensity of Walking Affect Knee Osteoarthritis?
Source: Wikimedia commons and sven.h
#osteoarthritisSecondary#knee

Do people with or have high risk of knee osteoarthritis (OA) need to walk more to avoid developing a slow gait speed?

This is one of the questions researchers were asking in their recent study, “Does the intensity of daily walking matter for protecting against the development of a slow gait speed in people with or at high risk of knee osteoarthritis? An observational study”. This study appears in the 2018 edition of the Osteoarthritis and Cartilage Journal. 

According to the study investigators, “We used baseline and 2-year follow-up data from the Multicenter Osteoarthritis (MOST) study and the Osteoarthritis Initiative. Daily walking intensity was objectively assessed using accelerometer-enabled devices and classified as: not walking (>1 steps/min), very light (1-49 steps/min), light (50-100 steps/min), and moderate-to-vigorous (>100 steps/min). We defined slaw gait during a 20-m walk, as <1 m/s and <1.2 m/s. Isotemporal substitution evaluated time-substitution effects on incident slow gait outcomes at 2-years.”

“When possible, walking at a moderate-to-vigorous intensity (>100 steps/min) may be best recommended in order to reduce the risk of developing critical slow gait speed among people with, or at high risk of knee OA.”

Co-author S.A.M. Fenton, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, England, UK told OTW, “This topic was of interest to us because we wanted to know if the intensity of walking mattered with preventing future difficulty with physical function.”

“Previously we found that walking 6,000 steps/day best discriminated between those with knee OA who go on to developing problems with physical function, e.g., climbing stairs and getting out of bed, versus those who don’t.”

“But with this study we wanted to know if all steps were equal with preventing problems with physical function, or if some steps were more effective than others. What we found out was that not all steps were equal. Rather, walking at a moderate intensity, e.g., walking at a brisk pace or in a purposeful manner, is most effective for preventing future problems with physical function.”

“This is important to understand to encourage people with knee OA to walk, and when possible to walk at a brisk or moderate past.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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