Disclosures: Lo reports receiving funding support from the NIH/NIAMS and Tufts Medical Center.
June 22, 2022
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Patients with osteoarthritis who walk for exercise less likely to develop new knee pain

Disclosures: Lo reports receiving funding support from the NIH/NIAMS and Tufts Medical Center.
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Walking for exercise appears to reduce pain progression in patients aged 50 years or older with knee osteoarthritis, according to data published in Arthritis & Rheumatology.

“To conduct this study, we used data from the Osteoarthritis Initiative, a research endeavor that has been funded by the NIH and pharma partners for many years,” Grace H. Lo, MD, MSc, assistant professor of medicine at the Baylor College of Medicine, and chief of rheumatology and investigator at the Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center in Houston, told Healio. “We wanted to know the influence of walking on those with osteoarthritis.

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Walking for exercise appears to reduce pain progression in patients aged 50 years or older with knee OA, according to data.

“Because osteoarthritis is the most common form of arthritis, where 30% of people aged 60 or older have knee osteoarthritis, the public health implications of these findings are potentially substantial,” Lo added.

To examine the impact of walking for exercise on patients aged 50 years and older with OA, Lo and colleagues conducted a nested cohort analysis of a subset of participants from the Osteoarthritis Initiative (OAI), a prospective, longitudinal, observational, multicenter study that enrolled patients with symptomatic knee OA from 2004 through 2006. Participants received annual evaluations from baseline through 48 months, and then every 2 years through 96 months, the authors wrote.

To be eligible to participate, patients were required to be aged 50 years or older with complete data on knee-specific pain, and knee radiographs, at baseline and 36- or 48-month visits. Additionally, patients needed to complete a modified Historical Physical Activity Survey at 96 months and radiographic evidence of OA in the knee at baseline.

Most radiographs present were from baseline and the 48-month visits, according to the researchers. In cases where no radiograph present from the 48-month visit, a scan from 36 months was used. Researchers used the modified Historical Physical Activity Score survey to measure patients’ exposure to walking for exercise. The survey was available to take at the patients’ homes. Participants were also asked to complete the survey at the 96-month visit. Researchers measured new frequent knee pain, improved frequent knee pain, medial joint space narrowing worsening and Kellgren-Lawrence grade worsening.

The current analysis included 1,212 patients with 1,808 affected knees. Of those included, 73% reported walking for exercise. According to the researchers, new frequent knee pain was less common in patients who reported walking for exercise; these patients also demonstrated 40% smaller odds of developing new pain (OR = 0.6; 95% CI, 0.4-0.8). Additionally, medial joint space narrowing was less common in patients who reported walking (OR = 0.8; 95% CI, 0.6-1).

“These findings suggest that those who walk for exercise might be less likely to develop symptoms,” Lo said. “However, when we looked at those who did already have regular knee pain at the beginning of the study, those who walked for exercise had the same number of people who had improvement of their knee pain.

“The idea here being that prevention is the key,” Lo added. “If you can catch people before they get regular symptoms and get them to walk, this might be very helpful in preventing the development of regular knee pain. The opportunity might already be lost once regular knee pain has already occurred.”