Knee pain not linked to daily walking levels in mild, moderate knee OA

Knee pain is not associated with the number of steps per day walked among patients with mild or moderate symptomatic knee osteoarthritis, according to findings published in Arthritis Care & Research.

OssKin Evoke

by Jason Laday, Healio March 14, 2019

“Knee osteoarthritis is a common, painful and often debilitating disease,” Monica R. Maly PhD, of McMaster University and the University of Waterloo, Ontario, Canada, told Healio Rheumatology. “People who have knee osteoarthritis also tend to experience other chronic health conditions, including — but not limited to — obesity, heart disease and depression. Physical inactivity may be a common denominator that worsens both osteoarthritis and these other chronic health conditions.”

To evaluate the links between two distinct knee-pain measures and physical activity among adults with knee OA, Maly and colleagues conducted a longitudinal, observational study of 59 patients aged 40 to 70 years, recruited from rheumatology and orthopedic surgery offices at McMaster University. The researchers defined physical activity in terms of average steps taken per day over a period of at least 3 days. Steps were measured via accelerometer. Pain was measured using two patient-administered surveys — the Knee injury and Osteoarthritis Outcome Score (KOOSpain) and P4 pain scale (P4pain).

Maly and colleagues collected data every 3 months for up to 3 years. They used mixed effects models to determine the associations between pain and physical activity, over covariates, including age, BMI and season.

According to the researchers, all covariates, including age (beta = –3.65; P < .001), BMI (beta = –3.06; P < .001) and season — specifically spring and fall (beta = –6.91; P = .002) and winter (beta = –14.92; P .001) — were predictors of physical activity. Neither the KOOS-pain (beta = 0.04; P = .717) nor the P4pain (beta = –0.37; P = .264) measures were associated with physical activity.

“This study highlights that we cannot expect pain and physical activity to be linked — some individuals with a great deal of pain may continue to be active, while others with relatively little pain may be sedentary,” Maly said. “The best care for people living with knee osteoarthritis will focus on managing pain, but also on boosting physical activity to promote well-being. In order to promote the best health, care for people living with knee osteoarthritis must focus on both managing pain and overcoming barriers to physical activity.”

Disclosure: Maly reports no relevant financial disclosures. Please see the study for all other relevant financial disclosures.

Source Healio


Pain Is Not Associated with Steps per Day in Persons with Mild-to-Moderate, Symptomatic Knee Osteoarthritis – A Mixed Models Analysis of Multiple Measurements over 3 Years, Brisson NM, Gatti AA, Maly MR. Arthritis Care Res (Hoboken). 2019 Mar 6. doi: 10.1002/acr.23842. [Epub ahead of print]

Objective assessment of physical activity and sedentary behaviour in knee osteoarthritis patients – beyond daily steps and total sedentary time, Sliepen M, Mauricio E, Lipperts M, Grimm B, Rosenbaum D. BMC Musculoskelet Disord. 2018 Feb 23;19(1):64. doi: 10.1186/s12891-018-1980-3. Full text, PDF

  Further reading

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, Brisson NM, Gatti AA, Maly MR. Arthritis Care Res (Hoboken). 2020 Jan;72(1):114-121. doi: 10.1002/acr.23842.

Also see
EULAR recommends physical activity as part of standard care for inflammatory arthritis, OA Healio
New biomechanical footwear system relieves knee OA pain Healio

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