Knee OA: Predictors and Outcomes of Physical Inactivity-Activity Transitions

描述(由申请人提供)：这项研究调查了一种扩展的范例，通过改变膝骨性关节炎(OA)人群居住的低端体力活动谱来改善膝骨性关节炎(OA)成人的健康结果。我们最近的研究发现，根据美国卫生与公众服务部(DHHS)的定义，几乎一半的膝盖骨关节炎成年人处于不活动状态(即一周内没有持续10分钟的中等到剧烈强度的体力活动)，这是基于客观加速度计对体力活动的测量。正是这些不活跃的人将成为这一事件的主要焦点 学习。此次更新将调查与从缺乏运动状态过渡到不运动状态相关的预测因素和健康结果。它还将确定维持功能和减少残疾所需的循证体力活动指标和阈值。这项研究建立在我们目前从骨关节炎倡议(OAI)资助的工作基础上，OAI是一项前瞻性、观察性、队列研究 患有或处于膝骨性关节炎高危人群的成年人，包括膝关节骨性关节炎疾病的所有严重程度。这项提案将利用由上级研究收集的OAI国家队列(n=2015)中的一个子样本，利用加速计测量的有价值的客观纵向体力活动数据，以实现以下技术目标：将加速度计输出处理为可用的体力活动测量，并确定每个人的不活动/活动转换状态。目标 1.评估从静止到活动的转变(T0到T1)与初始活动和未来残疾和功能变化之间的关系，控制基线总活动量，描述性 因素和可修改的因素。此目标与临床实践目标2相关。在基线状态下，在不活跃的成人中检查总活动量(T0至T1)的变化与最初和将来的残疾和功能变化之间的关系，控制基线总活动量、描述性因素和可修改因素。这一目标与公共卫生干预措施的设计有关。目标3.确定变得不活跃的预测因素。这一目标与公共政策设计有关。目的4.开发基于证据的体力活动指标，以预测高危成人或膝骨性关节炎患者(基线时活动和不活动)的短期(T0到T1)功能和长期(T0到T2)残疾结果。这一目标与完善体育锻炼公共健康建议有关。这项拟议研究的发现对设计未来的体力活动干预计划具有重要的公共卫生意义，以提高 2100万患有膝骨性关节炎的美国成年人的生活。

DESCRIPTION (provided by applicant): This study investigates an expanded paradigm to improve health outcomes for adults with knee osteoarthritis (OA), through changes in the low end of the physical activity spectrum where much of the knee OA population resides. Our recent study found almost half of adults with knee OA were inactive, as defined by the US Department of Health and Human Services (DHHS) (i.e., no sustained 10 minute periods of moderate-to- vigorous intensity physical activity during a week) based on objective accelerometer measurement of physical activity. It is these inactive people who will be the primary focus of this study. This renewal will investigate predictors and health outcomes related to transitions from and to physical inactivity. It will also to identify evidence-based physical activity metrics and thresholds needed to maintain function and reduce disability. The study builds on our current funded work from the Osteoarthritis Initiative (OAI), a prospective, observational, cohort study of adults with or at high risk for knee OA that encompasses the full spectrum of knee OA disease severity. This proposal will utilize valuable objective longitudinal physical activity data measure by accelerometer on a subsample from the OAI national cohort (n=2015) collected by the parent study to accomplish the following: Technical Aim. Process accelerometer output into usable physical activity measures and determine inactivity/activity transition status for each person. Aim 1. Evaluate the relationship between a transition from inactivity to activity (T0 toT1) with initia and future changes in disability and function, controlling for baseline total activity, descriptive factors, and modifiable factors. This aim is relevant to clinical practice Aim 2. Examine among inactive adults at baseline the relationship between the change in total activity (T0 toT1) with initial and future changes in disability and function, controlling for baseline total activity, descriptive factors, and modifiable factors. This aim is relevant to the design of public health interventions. Aim 3. Identify predictors of becoming inactive. This aim is relevant to public policy design. Aim 4. Develop evidence-based physical activity metrics to predict short-term (T0 toT1) function and long- term (T0 toT2) disability outcomes among adults at high risk or with knee OA (both active and inactive at baseline). This aim is relevant to refining physical activity public health recommendations. Findings from this proposed study have important public health implications for the design of future physical activity intervention programs to improve quality of life among the 21 million U.S. adults who have knee OA.