Change in physical activity level and clinical outcomes in older adults with knee pain: a secondary analysis from a randomised controlled trial

Quicke, Jonathan G. and Foster, Nadine E. and Croft, Peter R. and Ogollah, Reuben O. and Holden, Melanie A. (2018) Change in physical activity level and clinical outcomes in older adults with knee pain: a secondary analysis from a randomised controlled trial. BMC Musculoskeletal Disorders, 19 . 59/1-59/9. ISSN 1471-2474

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Abstract

BACKGROUND:

Exercise interventions improve clinical outcomes of pain and function in adults with knee pain due to osteoarthritis and higher levels of physical activity are associated with lower severity of pain and higher levels of physical functioning in older adults with knee osteoarthritis in cross-sectional studies. However, to date no studies have investigated if change in physical activity level during exercise interventions can explain clinical outcomes of pain and function. This study aimed to investigate if change in physical activity during exercise interventions is associated with future pain and physical function in older adults with knee pain.

METHODS:

Secondary longitudinal data analyses of a three armed exercise intervention randomised controlled trial. Participants were adults with knee pain attributed to osteoarthritis, over the age of 45 years old (n = 514) from Primary Care Services in the Midlands and Northwest regions of England. Crude and adjusted associations between absolute change in physical activity from baseline to 3 months (measured by the self-report Physical Activity Scale for the Elderly (PASE)) and i) pain ii) physical function (Western Ontario and McMaster Universities Osteoarthritis Index) and iii) treatment response (OMERACT-OARSI responder criteria) at 3 and 6 months follow-up were investigated using linear and logistic regression.

RESULTS:

Change in physical activity level was not associated with future pain, function or treatment response outcomes in crude or adjusted models at 3 or 6 months (P > 0.05). A 10 point increase in PASE was not associated with pain β = - 0.01 (- 0.05, 0.02), physical function β = - 0.09 (- 0.19, 0.02) or likelihood (odds ratio) of treatment response 1.02 (0.99, 1.04) at 3 months adjusting for sociodemographics, clinical covariates and the trial intervention arm. Findings were similar for 6 month outcome models.

CONCLUSIONS:

Change in physical activity did not explain future clinical outcomes of pain and function in this study. Other factors may be responsible for clinical improvements following exercise interventions. However, the PASE may not be sufficiently responsive to measure change in physical activity level. We also recommend further investigation into the responsiveness of commonly used physical activity measures.

TRIAL REGISTRATION:

( ISRCTN93634563 ). Registered 29th September 2011.

Item Type: Article
Keywords: Osteoarthritis, Knee, Pain, Physical activity, Exercise, Geriatrics
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Units > Clinical Trials Unit
Identification Number: 10.1186/s12891-018-1968-z
Depositing User: Ogollah, Reuben
Date Deposited: 28 Mar 2018 13:22
Last Modified: 29 Mar 2018 02:01
URI: http://eprints.nottingham.ac.uk/id/eprint/50759

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