Effects of interaction between varus thrust and ambulatory physical activity on knee pain in individuals with knee osteoarthritis: an exploratory study with 12-month follow-up

Hirotaka Iijima, Tomoki Aoyama, Ryo Eguchi, Masaki Takahashi, Shuichi Matsuda

Research output: Contribution to journalArticle

Abstract

Introduction: This study aimed to examine the interaction effect between ambulatory physical activity (PA) and varus thrust on knee pain in individuals with knee osteoarthritis (OA). Method: Subjects (n = 207; mean age: 73.1 years, 71.5% women) in orthopedic clinics with diagnosed knee OA (Kellgren/Lawrence grade ≥ 1) were enrolled in this 12-month observational cohort study. Participants underwent gait observation for varus thrust assessment and pedometer-based ambulatory PA measurements at baseline and 12-month follow-up. Knee pain intensity was assessed using the Japanese Knee Osteoarthritis Measure pain subscale as a primary outcome measure. Multiple linear regression analyses were performed to evaluate ambulatory PA–thrust interaction on knee pain intensity. Results: Ninety-two subjects (mean age, 73.4 years; 68.5% women) completed the 12-month follow-up assessment. Baseline ambulatory PA–thrust interaction was significant (P = 0.017) in the cross-sectional analysis, adjusting for covariates, which yielded R 2 = 0.310. Subgroup analysis showed that varus thrust was significantly associated with worse knee pain in subjects walking ≥ 5000 steps/day adjusting for covariates (beta: 7.94; 95% CI: 3.82, 12.1; P < 0.001) with a higher predictive ability (R 2 = 0.664). In contrast, ambulatory PA–thrust interaction in the longitudinal analysis showed no significant association with knee pain changes. Conclusions: Ambulatory PA interacted with varus thrust in the association with knee pain, as coexisting high ambulatory PA and varus thrust had the strongest association with higher knee pain. Maximal pain relief effects might be achieved when both ambulatory PA and varus thrust are treated simultaneously, rather than treating each separately.

Original languageEnglish
JournalClinical Rheumatology
DOIs
Publication statusPublished - 2019 Jan 1

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Knee Osteoarthritis
Knee
Exercise
Pain
Aptitude
Gait
Walking
Observational Studies
Orthopedics
Linear Models
Cohort Studies
Cross-Sectional Studies
Regression Analysis
Observation
Outcome Assessment (Health Care)

Keywords

  • Interaction
  • Knee pain
  • Physical activity
  • Varus thrust

ASJC Scopus subject areas

  • Rheumatology

Cite this

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title = "Effects of interaction between varus thrust and ambulatory physical activity on knee pain in individuals with knee osteoarthritis: an exploratory study with 12-month follow-up",
abstract = "Introduction: This study aimed to examine the interaction effect between ambulatory physical activity (PA) and varus thrust on knee pain in individuals with knee osteoarthritis (OA). Method: Subjects (n = 207; mean age: 73.1 years, 71.5{\%} women) in orthopedic clinics with diagnosed knee OA (Kellgren/Lawrence grade ≥ 1) were enrolled in this 12-month observational cohort study. Participants underwent gait observation for varus thrust assessment and pedometer-based ambulatory PA measurements at baseline and 12-month follow-up. Knee pain intensity was assessed using the Japanese Knee Osteoarthritis Measure pain subscale as a primary outcome measure. Multiple linear regression analyses were performed to evaluate ambulatory PA–thrust interaction on knee pain intensity. Results: Ninety-two subjects (mean age, 73.4 years; 68.5{\%} women) completed the 12-month follow-up assessment. Baseline ambulatory PA–thrust interaction was significant (P = 0.017) in the cross-sectional analysis, adjusting for covariates, which yielded R 2 = 0.310. Subgroup analysis showed that varus thrust was significantly associated with worse knee pain in subjects walking ≥ 5000 steps/day adjusting for covariates (beta: 7.94; 95{\%} CI: 3.82, 12.1; P < 0.001) with a higher predictive ability (R 2 = 0.664). In contrast, ambulatory PA–thrust interaction in the longitudinal analysis showed no significant association with knee pain changes. Conclusions: Ambulatory PA interacted with varus thrust in the association with knee pain, as coexisting high ambulatory PA and varus thrust had the strongest association with higher knee pain. Maximal pain relief effects might be achieved when both ambulatory PA and varus thrust are treated simultaneously, rather than treating each separately.",
keywords = "Interaction, Knee pain, Physical activity, Varus thrust",
author = "Hirotaka Iijima and Tomoki Aoyama and Ryo Eguchi and Masaki Takahashi and Shuichi Matsuda",
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T1 - Effects of interaction between varus thrust and ambulatory physical activity on knee pain in individuals with knee osteoarthritis

T2 - an exploratory study with 12-month follow-up

AU - Iijima, Hirotaka

AU - Aoyama, Tomoki

AU - Eguchi, Ryo

AU - Takahashi, Masaki

AU - Matsuda, Shuichi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: This study aimed to examine the interaction effect between ambulatory physical activity (PA) and varus thrust on knee pain in individuals with knee osteoarthritis (OA). Method: Subjects (n = 207; mean age: 73.1 years, 71.5% women) in orthopedic clinics with diagnosed knee OA (Kellgren/Lawrence grade ≥ 1) were enrolled in this 12-month observational cohort study. Participants underwent gait observation for varus thrust assessment and pedometer-based ambulatory PA measurements at baseline and 12-month follow-up. Knee pain intensity was assessed using the Japanese Knee Osteoarthritis Measure pain subscale as a primary outcome measure. Multiple linear regression analyses were performed to evaluate ambulatory PA–thrust interaction on knee pain intensity. Results: Ninety-two subjects (mean age, 73.4 years; 68.5% women) completed the 12-month follow-up assessment. Baseline ambulatory PA–thrust interaction was significant (P = 0.017) in the cross-sectional analysis, adjusting for covariates, which yielded R 2 = 0.310. Subgroup analysis showed that varus thrust was significantly associated with worse knee pain in subjects walking ≥ 5000 steps/day adjusting for covariates (beta: 7.94; 95% CI: 3.82, 12.1; P < 0.001) with a higher predictive ability (R 2 = 0.664). In contrast, ambulatory PA–thrust interaction in the longitudinal analysis showed no significant association with knee pain changes. Conclusions: Ambulatory PA interacted with varus thrust in the association with knee pain, as coexisting high ambulatory PA and varus thrust had the strongest association with higher knee pain. Maximal pain relief effects might be achieved when both ambulatory PA and varus thrust are treated simultaneously, rather than treating each separately.

AB - Introduction: This study aimed to examine the interaction effect between ambulatory physical activity (PA) and varus thrust on knee pain in individuals with knee osteoarthritis (OA). Method: Subjects (n = 207; mean age: 73.1 years, 71.5% women) in orthopedic clinics with diagnosed knee OA (Kellgren/Lawrence grade ≥ 1) were enrolled in this 12-month observational cohort study. Participants underwent gait observation for varus thrust assessment and pedometer-based ambulatory PA measurements at baseline and 12-month follow-up. Knee pain intensity was assessed using the Japanese Knee Osteoarthritis Measure pain subscale as a primary outcome measure. Multiple linear regression analyses were performed to evaluate ambulatory PA–thrust interaction on knee pain intensity. Results: Ninety-two subjects (mean age, 73.4 years; 68.5% women) completed the 12-month follow-up assessment. Baseline ambulatory PA–thrust interaction was significant (P = 0.017) in the cross-sectional analysis, adjusting for covariates, which yielded R 2 = 0.310. Subgroup analysis showed that varus thrust was significantly associated with worse knee pain in subjects walking ≥ 5000 steps/day adjusting for covariates (beta: 7.94; 95% CI: 3.82, 12.1; P < 0.001) with a higher predictive ability (R 2 = 0.664). In contrast, ambulatory PA–thrust interaction in the longitudinal analysis showed no significant association with knee pain changes. Conclusions: Ambulatory PA interacted with varus thrust in the association with knee pain, as coexisting high ambulatory PA and varus thrust had the strongest association with higher knee pain. Maximal pain relief effects might be achieved when both ambulatory PA and varus thrust are treated simultaneously, rather than treating each separately.

KW - Interaction

KW - Knee pain

KW - Physical activity

KW - Varus thrust

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