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      Walking ability during daily life in patients with osteoarthritis of the knee or the hip and lumbar spinal stenosis: a cross sectional study

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          Abstract

          Background

          Degenerative musculoskeletal disorders are among the most frequent diseases occurring in adulthood, often impairing patients' functional mobility and physical activity. The aim of the present study was to investigate and compare the impact of three frequent degenerative musculoskeletal disorders -- knee osteoarthritis (knee OA), hip osteoarthritis (hip OA) and lumbar spinal stenosis (LSS) -- on patients' walking ability.

          Methods

          The study included 120 participants, with 30 in each patient group and 30 healthy control individuals. A uniaxial accelerometer, the StepWatch™ Activity Monitor (Orthocare Innovations, Seattle, Washington, USA), was used to determine the volume (number of gait cycles per day) and intensity (gait cycles per minute) of walking ability. Non-parametric testing was used for all statistical analyses.

          Results

          Both the volume and the intensity of walking ability were significantly lower among the patients in comparison with the healthy control individuals (p < 0.001). Patients with LSS spent 0.4 (IQR 2.8) min/day doing moderately intense walking (>50 gait cycles/min), which was significantly lower in comparison with patients with knee and hip OA at 2.5 (IQR 4.4) and 3.4 (IQR 16.1) min/day, respectively (p < 0.001). No correlations between demographic or anthropometric data and walking ability were found. No technical problems or measuring errors occurred with any of the measurements.

          Conclusions

          Patients with degenerative musculoskeletal disorders suffer limitations in their walking ability. Objective assessment of walking ability appeared to be an easy and feasible tool for measuring such limitations as it provides baseline data and objective information that are more precise than the patients' own subjective estimates. In everyday practice, objective activity assessment can provide feedback for clinicians regarding patients' performance during everyday life and the extent to which this confirms the results of clinical investigations. The method can also be used as a way of encouraging patients to develop a more active lifestyle.

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          Limits to the measurement of habitual physical activity by questionnaires.

          R J Shephard (2003)
          Despite extensive use over 40 years, physical activity questionnaires still show limited reliability and validity. Measurements have value in indicating conditions where an increase in physical activity would be beneficial and in monitoring changes in population activity. However, attempts at detailed interpretation in terms of exercise dosage and the extent of resulting health benefits seem premature. Such usage may become possible through the development of standardised instruments that will record the low intensity activities typical of sedentary societies, and will ascribe consistent biological meaning to terms such as light, moderate, and heavy exercise.
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            Lifetime risk of symptomatic knee osteoarthritis.

            Louise Murphy, Todd Schwartz, Charles G Helmick … (2008)
            To estimate the lifetime risk of symptomatic knee osteoarthritis (OA), overall and stratified by sex, race, education, history of knee injury, and body mass index (BMI). The lifetime risk of symptomatic OA in at least 1 knee was estimated from logistic regression models with generalized estimating equations among 3,068 participants of the Johnston County Osteoarthritis Project, a longitudinal study of black and white women and men age >or=45 years living in rural North Carolina. Radiographic, sociodemographic, and symptomatic knee data measured at baseline (1990-1997) and first followup (1999-2003) were analyzed. The lifetime risk of symptomatic knee OA was 44.7% (95% confidence interval [95% CI] 40.0-49.3%). Cohort members with history of a knee injury had a lifetime risk of 56.8% (95% CI 48.4-65.2%). Lifetime risk rose with increasing BMI, with a risk of 2 in 3 among those who were obese. Nearly half of the adults in Johnston County will develop symptomatic knee OA by age 85 years, with lifetime risk highest among obese persons. These current high risks in Johnston County may suggest similar risks in the general US population, especially given the increase in 2 major risk factors for knee OA, aging, and obesity. This underscores the immediate need for greater use of clinical and public health interventions, especially those that address weight loss and self-management, to reduce the impact of having knee OA.
            Article 0 comments Cited 290 times – based on 0 reviews     Review now
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              Challenges and opportunities for measuring physical activity in sedentary adults.

              Teresa A. Myers, Dona Locke (2001)
              Increasing the physical activity of typically sedentary adult populations is at the forefront of the public health agenda. This review addresses the challenges in defining and measuring physical activity in this target group, for a number of purposes, namely, scientific or academic inquiry, surveillance, clinical application and programme evaluation. First, we clarify the conceptual distinctions between the terms sedentarism, physical inactivity, physical activity and energy expenditure. Next, we review and compare the utility of different approaches for quantifying and expressing physical activity in these populations. Physical activity in typically sedentary populations is most likely a simple pattern of behaviour that has been largely obscured by existing measures and its expression as energy expenditure. Existing self-report methods are practical, but suffer from floor effects and recall bias. Walking, the most important activity to assess in this target group, is very difficult to measure through self-report methods. Motion sensors are more appropriate for quantifying physical activity behaviours in typically sedentary populations. Of the 2 types of motion sensors - the accelerometer and the pedometers--the latter is more appealing because it is both an affordable and a 'good enough' measure of physical activity, specifically ambulatory activity. Although a common measurement approach would greatly facilitate our understanding of physical activity behaviour patterns, the selection of an approach ultimately depends on the purpose of the study and to a great extent, its budget. Researchers, clinicians and practitioners interested in accurately capturing the lower end of the continuum of physical activity (that is characteristic of sedentary populations) must thoughtfully consider the relative advantages and disadvantages of the available approaches.
              Article 0 comments Cited 106 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMC Musculoskelet Disord
                Title: BMC Musculoskeletal Disorders
                Publisher: BioMed Central
                ISSN (Electronic): 1471-2474
                Publication date Collection: 2010
                Publication date (Electronic): 12 October 2010
                Volume: 11
                Page: 233
                Affiliations
                [1 ]Department of Orthopedics and Tumor Orthopedics, University Hospital Muenster, Albert-Schweitzer-Str. 33, 48149 Münster, Germany
                [2 ]Institute of Sports Science, University of Bremen, Badgasteiner-Str. 1, 28359 Bremen, Germany
                [3 ]Orthopedic Department, Klinikum Ingolstadt, Krumenauerstr. 25, 85021 Ingolstadt, Germany
                Article
                Publisher ID: 1471-2474-11-233
                DOI: 10.1186/1471-2474-11-233
                PMC ID: 2958990
                PubMed ID: 20939866
                SO-VID: 8c0027f7-dee3-4e89-a62d-2ee61906a132
                Copyright © Copyright ©2010 Winter et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 January 2010
                Date accepted : 12 October 2010
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Orthopedics
                Data availability:
                ScienceOpen disciplines: Orthopedics

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