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

描述（由申请人提供）：本研究调查了一种扩展模式，通过改变大部分膝关节骨关节炎人群所在的体力活动谱低端，改善膝关节骨关节炎（OA）成人的健康结局。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，几乎一半的膝关节OA成人不活动（即，在一周内没有持续10分钟的中等到剧烈强度的身体活动）。这是这些不活跃的人谁将是主要的重点， study.这次更新将调查与从身体活动不足过渡到身体活动不足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身体活动指标和阈值。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， 患有膝关节骨性关节炎或膝关节骨性关节炎高风险的成人，包括膝关节骨性关节炎疾病严重程度的全谱。本提案将利用加速计对母研究收集的OAI国家队列（n=2015）子样本测量的有价值的客观纵向身体活动数据，以实现以下目标：技术目标。将加速度计输出处理为可用的身体活动测量值，并确定每个人的不活动/活动转换状态。目的 1.评价从不活动到活动（T0到T1）的转变与初始和未来残疾和功能变化之间的关系，控制基线总活动，描述性 因素和可变因素。该目标与临床实践目标2相关。检查基线时非活动成年人的总活动变化（T0至T1）与残疾和功能的初始和未来变化之间的关系，控制基线总活动、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。目标4。制定循证体力活动指标，以预测高风险或膝关节OA成人（基线时活动和非活动）的短期（T0至T1）功能和长期（T0至T2）残疾结局。这一目标与完善身体活动公共卫生建议有关。这项拟议研究的结果对未来身体活动干预计划的设计具有重要的公共卫生意义， 美国2100万膝关节骨性关节炎患者的生活。

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.