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: 7686145
• 负责人: DOROTHY D. DUNLOP
• 金额: $ 51.59万
• 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/7686145
• 关键词: Ache; Activities of Daily Living; Address; Adult; Age; American; Ancillary Study; Arthritis; Arts; Bilateral; Body mass index; Cardiovascular Physiology; 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; 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; Preventive Intervention; Public Health; Quality of life; Questionnaires; Race; Recommendation; Rheumatism; Risk; Risk Factors; Role; Seasons; Severities; Smoke; Smoking; Societies; Speed; Surgeon; Symptoms; Telephone Interviews; Testing; Time; Translating; Vascular Diseases; Visit; Walking; advanced disease; base; cigarette smoking; cohort; community living; cost; depressive symptoms; design; disability; epidemiology study; handicapping condition; high risk; improved; improved functioning; instrument; instrumental activity of daily living; intervention program; 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（由申请人提供）：身体活动对膝关节骨关节炎残疾进展的影响近800万美国人因关节炎而残疾，使关节炎成为美国残疾的主要原因。关节炎相关残疾的主要原因是膝关节骨关节炎（OA）。虽然体力活动可以改善关节炎患者的健康状况，但尚不清楚体力活动是否会减少残疾进展，这是OA患者医疗保健费用的关键驱动因素。初步证据表明，体育活动对减少关节炎成人残疾进展的潜在益处可能在疾病不太严重的人中更大。从公共卫生的角度来看，建立早期膝关节OA的获益对于适当针对成年人的体育活动计划具有重要意义。为了全面研究膝关节骨性关节炎中体力活动的流行病学以及较高体力活动水平对残疾进展的影响，提出了骨关节炎倡议（OAI）纵向研究的辅助研究。OAI包括膝关节OA疾病的全谱。这项辅助研究包括2280名患有症状性膝关节骨性关节炎或有发生症状性膝关节骨性关节炎高风险的OAI受试者。将使用加速度计客观测量身体活动，以量化活动频率、持续时间和强度，并确定身体活动指南的实现情况。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。将检验以下假设。1.达到USSG（美国外科医生一般身体活动建议）指南推荐的身体活动目标的人与未达到者相比，两年内残疾进展的风险较低。与有症状的患者相比，无症状膝关节OA患者达到指南的获益更大。2.与非参加者相比，达到USSG针对关节炎修改的身体活动目标的人在两年内残疾进展的风险较低。与有症状的患者相比，无症状膝关节OA患者的这种获益更强。3.体力活动水平与残疾进展之间存在剂量反应关系。处于最高与中间体力活动三分位数和中间与底部三分位数的人在两年内残疾进展的风险较低。分析将调整膝关节症状和疾病的X光片证据的存在以及潜在的混杂因素，包括膝关节疼痛强度、年龄、性别、种族、体重指数、吸烟、经济因素和医学合并症。这项研究的结果将推动公共卫生工作，以减少残疾，并改善2100万美国膝关节OA成年人的生活质量。PHS 398/2590（修订版09/04）第1页续格式页本研究将检查达到推荐的公共卫生体力活动指南是否可防止有症状性膝关节骨关节炎或有发生症状性膝关节骨关节炎的高风险人群的残疾进展，以及达到指南是否可为无症状性疾病的人群提供更大的获益。这项研究的结果将推动公共卫生工作，以减少残疾，并改善2100万美国膝关节OA成年人的生活质量。PHS 398/2590（Rev. 09/04）第1页