4 years ago

Minimum performance on clinical tests of physical function to predict walking 6000 steps/day in knee osteoarthritis: An observational study

Emily Polakowski, Louise M. Thoma, Hiral Master, Daniel K. White, Laura A. Schmitt, Meredith B. Christiansen
Objective Evidence of physical function difficulties, such as difficulty rising from a chair, may limit daily walking for people with knee osteoarthritis (OA). The purpose of this study was to identify minimum performance thresholds on clinical tests of physical function predictive to walk ≥6000 steps/day. This benchmark is known to discriminate people with knee OA who develop functional limitation over time from those who do not. Methods Using data from the Osteoarthritis Initiative, we quantified daily walking as average steps/day from an accelerometer (Actigraph GTM1) worn for >10 hours/day over one week. Physical function was quantified using three performance-based clinical tests: five times sit to stand test, walking speed (tested over 20 meters) and 400-meter walk test. To identify minimum performance thresholds for daily walking, we calculated physical function values corresponding to high specificity (80 to 95%) to predict walking ≥6000 steps/day. Results Among 1925 participants (age [mean±sd] 65.1±9.1 years, BMI 28.4±4.8 kg/m2, 55% female) with valid accelerometer data, 54.9% walked ≥6000 steps/day. High specificity thresholds of physical function for walking ≥6000 steps/day ranged from 11.4 to 14.0 sec on the five times sit to stand test, 1.13 to 1.26 meters/sec for walking speed, or 315 to 349 sec on the 400-meter walk test. Conclusion Not meeting these minimum performance thresholds on clinical tests of physical function may indicate inadequate physical ability to walk ≥6000 steps/day for people with knee OA. Rehabilitation may be indicated to address underlying impairments limiting physical function. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/acr.23448

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