Relationship of Meeting Physical Activity Guidelines With Health-Related Utility
ABSTRACT Objective: Health-related utility measures overall health status and quality of life and is commonly incorporated into cost-effectiveness analyses. This study investigates whether attainment of federal physical activity guidelines translates into better health-related utility in adults with or at risk for knee osteoarthritis (OA). Methods: Cross-sectional data from 1908 adults with or at risk for knee OA participating in the accelerometer ancillary study of the Osteoarthritis Initiative (OAI) were assessed. Physical activity was measured using 7 days of accelerometer monitoring and was classified as 1) Meeting Guidelines (≥150 bouted moderate-to-vigorous [MV] minutes per week); 2) Insufficiently Active (≥1 MV bout[s] per week but below guidelines); or 3) Inactive (zero MV bouts per week). A Short Form 6D (SF6-D) health-related utility score was derived from patient-reported health status. Relationship of physical activity levels to median health-related utility adjusted for socioeconomic and health factors was tested using quantile regression. Results: Only 13% of participants met physical activity guidelines; 45% were inactive. Relative to the Inactive, median health-related utility scores were significantly greater for the Meeting Guidelines (0.063; confidence interval [CI] 0.055-0.071) and Insufficiently Active (0.059; CI 0.054-0.064) groups. These differences showed a statistically significant linear trend and strong cross-sectional relationship with physical activity level even after adjusting for socioeconomic and health factors. Conclusions: We found a significant positive relationship between physical activity level and health-related utility. Interventions that encourage adults, including persons with knee OA, to increase physical activity even if recommended levels are not attained may improve their quality of life. © 2013 American College of Rheumatology.
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ABSTRACT: To investigate the association between baseline physical activity and 1-year functional performance in adults with knee osteoarthritis (OA). Prospective cohort study of knee OA development and progression with 1-year follow-up. Community. Osteoarthritis Initiative public data on adults with knee OA (n=2274; age, 45-79y) who participated in functional performance assessments (timed 20-m walk and chair stand test) at baseline and 1-year follow-up. Not applicable. A good 1-year performance outcome (separately defined for walk time and chair stand measures) was improvement from baseline quintile or maintenance in the best quintile. Almost 2 in 5 persons with radiographic knee OA improved or maintained high performance at 1 year. Physical activity measured by the Physical Activity Scale for the Elderly (PASE) was significantly associated with good walk rate and chair stand outcomes (odds ratio per 40 units PASE [95% confidence interval]=1.13 [1.13, 1.17] and 1.10 [1.05, 1.15], respectively), as were participation in sports/recreational activities (1.45 [1.23, 1.71] and 1.29 [1.09, 1.51], respectively) and lifestyle activities (1.11 [1.06, 1.16] and 1.09 [1.04, 1.14], respectively). An independent protective relationship for these physical activity measures approached significance after adjusting for sociodemographic and health factors. Older adults reported the least baseline physical activity and least frequent good 1-year outcomes. These findings support public health recommendations to be physically active in order to preserve function for persons with knee OA. Physical activity messages should specifically target older adults whose low activity levels may jeopardize their ability to maintain functional performance.Archives of physical medicine and rehabilitation 05/2010; 91(5):714-21. DOI:10.1016/j.apmr.2010.01.015 · 2.44 Impact Factor
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ABSTRACT: Osteoarthritis (OA) clinical practice guidelines identify a substantial therapeutic role for physical activity, but objective information about the physical activity of this population is lacking. The aim of this study was to objectively measure levels of physical activity in adults with knee OA and report the prevalence of meeting public health physical activity guidelines. Cross-sectional accelerometry data from 1,111 adults with radiographic knee OA (49-84 years old) participating in the Osteoarthritis Initiative accelerometry monitoring ancillary study were assessed for meeting the aerobic component of the 2008 Physical Activity Guidelines for Americans (≥150 minutes/week moderate-to-vigorous-intensity activity lasting ≥10 minutes). Quantile regression was used to test median sex differences in physical activity levels. Aerobic physical activity guidelines were met by 12.9% of men and 7.7% of women with knee OA. A substantial proportion of men and women (40.1% and 56.5%, respectively) were inactive, having done no moderate-to-vigorous activity that lasted 10 minutes or more during the 7 days. Although men engaged in significantly more moderate-to-vigorous activity (average daily minutes 20.7 versus 12.3), they also spent more time in no or very-low-intensity activity than women (average daily minutes 608.2 versus 585.8). Despite substantial health benefits from physical activity, adults with knee OA were particularly inactive based on objective accelerometry monitoring. The proportions of men and women who met public health physical activity guidelines were substantially less than those previously reported based on self-reported activity in arthritis populations. These findings support intensified public health efforts to increase physical activity levels among people with knee OA.Arthritis & Rheumatology 11/2011; 63(11):3372-82. DOI:10.1002/art.30562 · 7.87 Impact Factor
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ABSTRACT: We analyzed factors associated with improvement in walking ability among respondents to the nationally representative Health and Retirement Study. We analyzed data from 6574 respondents aged 53 years or older who reported difficulty walking several blocks, 1 block, or across the room in 2000 or 2002. We examined associations between improvement (versus no change, deterioration, or death) and baseline health status, chronic conditions, baseline walking difficulty, demographic characteristics, socioeconomic status, and behavioral risk factors. Among the 25% of the study population with baseline walking limitations, 29% experienced improved walking ability, 40% experienced no change in walking ability, and 31% experienced deteriorated walking ability or died. In a multivariate analysis, we found positive associations between walking improvement and more recent onset and more severe walking difficulty, being overweight, and engaging in vigorous physical activity. A history of diabetes, having any difficulty with activities of daily living, and being a current smoker were all negatively associated with improvement in walking ability. After we controlled for baseline health, improvement in walking ability was equally likely among racial and ethnic minorities and those with lower socioeconomic status. Interventions to reduce smoking and to increase physical activity may help improve walking ability in older Americans.American Journal of Public Health 03/2009; 99(3):533-9. DOI:10.2105/AJPH.2008.142927 · 4.23 Impact Factor