The Effect of Physical Activity on Disability Progression in Knee OA

体力活动对膝关节 OA 残疾进展的影响

• 批准号: 8131667
• 负责人: DOROTHY D. DUNLOP
• 金额: $ 32.13万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-08 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8131667
• 关键词: Ache; Activities of Daily Living; Address; Adult; Age; American; Ancillary Study; Arthritis; Bilateral; Body mass index; Cardiovascular system; Cerebrovascular Disorders; Classification; Clinical Data; Communities; Comorbidity; Congestive Heart Failure; Data; Data Set; Databases; Degenerative polyarthritis; Dementia; Dependency; Diabetes Mellitus; Diagnostic radiologic examination; Disabled Persons; Disease; Dose; Drug Formulations; Economic Factors; Education; Effectiveness; Epidemiology; Evaluation; Exercise; Frequencies; Funding; Gastrointestinal Diseases; Gender; Guidelines; Health; Health Benefit; Health Care Costs; Health Insurance; Image; Impairment; Income; Independent Living; Individual; International; Interview; Kidney Diseases; Knee; Knee Injuries; Knee Osteoarthritis; Link; Liver diseases; Longitudinal Studies; Lung diseases; Malignant Neoplasms; Measurement; Measures; Medical; Metabolic; Mission; Modeling; Monitor; Myocardial Infarction; Operative Surgical Procedures; Overweight; Pain; Participant; Patient Self-Report; Persons; Physical activity; Premature Mortality; Prevention program; Public Health; Quality of life; Questionnaires; Race; Recommendation; Rheumatism; Risk; Risk Factors; Role; Seasons; Severities; Smoking; Societies; Speed; Surgeon; Symptoms; Telephone Interviews; Testing; Time; Translating; Vascular Diseases; Visit; Walking; advanced disease; base; cigarette smoking; cohort; cost; depressive symptoms; design; disability; epidemiology study; high risk; improved; improved functioning; instrument; instrumental activity of daily living; intervention program; knee pain; meetings; mortality; programs; prospective; response; social; symposium; weapons; working group

DESCRIPTION (provided by applicant): The Effect of Physical Activity on Disability Progression in Knee Osteoarthritis Nearly 8 million Americans are disabled as a result of their arthritis, making arthritis the major cause of disability in the US. A leading cause of arthritis-related disability is knee osteoarthritis (OA). While physical activity improves the health of persons with arthritis, it is not known if physical activity reduces disability progression, a key driver of health care costs in persons with OA. Preliminary evidence indicates that the potential benefit from physical activity to reduce disability progression in adults with arthritis may be greater in persons having less severe disease. From a public health perspective, establishing a benefit in early knee OA has important implications to appropriately target physical activity programs for adults. To comprehensively examine the epidemiology of physical activity in knee OA and the effect of higher physical activity levels on disability progression, an ancillary study to the Osteoarthritis Initiative (OAI) longitudinal study is proposed. The OAI includes the full spectrum of knee OA disease. This ancillary study includes 2280 OAI participants having or at high risk for developing symptomatic knee OA. Physical activity will be objectively measured using accelerometers to quantify activity frequency, duration, and intensity and to ascertain physical activity guideline attainment. All data in the proposed ancillary study will join the OAI public data set. The following hypotheses will be tested. 1. Persons who attain USSG (U.S. Surgeon General physical activity recommendations) guideline- recommended physical activity targets have a lower risk of disability progression over two years compared to non-attainers. The benefit of guideline attainment is stronger for persons without symptomatic knee OA compared to persons having symptoms. 2. Persons who attain USSG physical activity targets modified for arthritis have a lower risk of disability progression over two years compared to non-attainers. This benefit is stronger for persons without symptomatic knee OA compared to persons having symptoms. 3. There is a dose response relationship between physical activity levels and disability progression. Persons in the top vs. middle physical activity tertiles and middle vs. bottom tertiles will have a lower risk of disability progression over two years. Analyses will adjust for the presence of knee symptoms and radiograph evidence of disease and for potential confounders, which include knee pain intensity, age, gender, race, body mass index, cigarette smoking, economic factors, and medical comorbidities. Findings from this study will advance public health efforts to reduce disability and to improve quality of life among 21 million U.S. adults having knee OA. PHS 398/2590 (Rev. 09/04) Page 1 Continuation Format Page This study will examine if attaining recommended public health physical activity guidelines protects against disability progression in persons having or at high risk for developing symptomatic knee osteoarthritis and if guideline attainment provides greater benefit for persons without symptomatic disease. Findings from this study will advance public health efforts to reduce disability and to improve quality of life among 21 million U.S. adults having knee OA. PHS 398/2590 (Rev. 09/04) Page 1 Continuation Format Page

描述(申请人提供)：体力活动对膝骨性关节炎残疾进展的影响近800万美国人因关节炎而致残，使关节炎成为美国残疾的主要原因。与关节炎相关的残疾的主要原因是膝骨性关节炎(OA)。虽然体力活动改善了关节炎患者的健康，但尚不清楚体力活动是否会减少残疾进展，这是关节炎患者医疗费用的关键驱动因素。初步证据表明，在患有关节炎的成年人中，从体育活动中减少残疾进展的潜在好处可能在病情较轻的人中更大。从公共卫生的角度来看，在早期膝关节骨性关节炎中确立一个益处对于适当地针对成年人的体育活动计划具有重要的意义。为了全面研究膝关节骨性关节炎患者体力活动的流行病学以及高体力活动水平对残疾进展的影响，对骨关节炎倡议(OAI)纵向研究提出了一项辅助研究。OAI包括膝骨性关节炎疾病的全部范围。这项辅助研究包括2280名患有或高危患膝关节骨性关节炎的OAI参与者。将使用加速计客观地测量体力活动，以量化活动频率、持续时间和强度，并确定体力活动指南的达标情况。拟议的辅助研究中的所有数据都将加入审调处的公共数据集。以下假设将得到检验。1.与未达到目标的人相比，达到USSG(美国外科医生总体力活动建议)指南推荐的体力活动目标的人在两年内残疾恶化的风险较低。与有症状的人相比，无症状性膝骨性关节炎患者达到指南的益处更大。2.达到针对关节炎修改的USSG体力活动目标的人与未达到目标的人相比，在两年内残疾恶化的风险较低。与有症状的人相比，对于没有症状的膝骨性关节炎患者，这一益处更大。3.体力活动水平与残疾进展之间存在剂量效应关系。在两年内，身体活动量最高的人与中等体力活动的人相比，中间的人与底部的人相比，残疾进展的风险更低。分析将根据膝部症状和疾病的X光证据的存在以及潜在的混杂因素进行调整，包括膝部疼痛强度、年龄、性别、种族、体重指数、吸烟、经济因素和医疗并存。这项研究的发现将推动公共卫生努力，以减少残疾并提高2100万患有膝骨性关节炎的美国成年人的生活质量。PHS 398/2590(Rev.09/04)第1页延续格式页面这项研究将研究达到推荐的公共卫生体力活动指南是否可以防止患有或高危患有症状性膝骨性关节炎的人的残疾进展，以及达到指南是否对没有症状性疾病的人有更大的好处。这项研究的发现将推动公共卫生努力，以减少残疾并提高2100万患有膝骨性关节炎的美国成年人的生活质量。PHS 398/2590(09/04版)第1页续格式页