Te. Mcalindon et al., Level of physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: The Framingham Study, AM J MED, 106(2), 1999, pp. 151-157
Citations number
42
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
PURPOSE: Because osteoarthritis may be caused by "wear and tear," we examin
ed the association between level of physical activity and risk of knee oste
oarthritis in the elderly.
SUBJECTS AND METHODS: Eligible subjects were participants in the Framingham
Heart Study cohort who had radiographically normal knees at biennial exam
18 (1983-1985) and who also completed a physical activity questionnaire at
exam 20 (1988-1989). Follow-up knee radiographs were obtained at biennial e
xam 22 (1992-1993). The study outcomes were the development of incident rad
iographic or symptomatic knee osteoarthritis between the baseline and follo
w-up exams.
RESULTS: The number of hours per day of heavy physical activity was associa
ted with the risk of incident radiographic knee osteoarthritis (odds ratio
= 1.3 per hour, 95% confidence limits 1.1-1.6, P for trend = 0.006). Adjust
ment for age, sex, body mass index, weight loss, knee injury, health status
, total calorie intake, and smoking strengthened this association (eg, odds
ratio for greater than or equal to 4 hours heavy physical activity/day com
pared with no heavy physical activity = 7.0, 95% confidence limits 2.4-20,
P for trend = 0.0002). Risk was greatest among individuals in the upper ter
tile of body mass index (odds ratio for greater than or equal to 3 hours/da
y of heavy physical activity = 13.0, 95% confidence limits 3.3-51). For inc
ident symptomatic knee osteoarthritis, the results were similar, although t
he number of cases was small. No effects on these outcomes were observed fr
om moderate and light physical activity, number of blocks walked, or number
of flights of stairs climbed daily.
CONCLUSIONS: Heavy physical activity is an important risk Factor for the de
velopment of knee osteoarthritis in the elderly, especially among obese ind
ividuals. Light and moderate activities do not appear to increase risk. Am
J Med. 1999;106: 151-157. (C) 1999 by Excerpta Medica, Inc.