Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms

Dorothy D. Dunlop, Jing Song, Jungwha Lee, Abigail L. Gilbert, Pamela A. Semanik, Linda Ehrlich-Jones, Christine A. Pellegrini, Daniel Pinto, Barbara Ainsworth, Rowland W. Chang

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To identify an evidence-based minimum physical activity threshold to predict improved or sustained high function for adults with lower-extremity joint symptoms. Methods: Prospective multisite data from 1,629 adults, age ≥49 years with symptomatic lower-extremity joint pain/aching/stiffness, participating in the Osteoarthritis Initiative accelerometer monitoring substudy were clinically assessed 2 years apart. Improved/high function in 2-year gait speed and patient-reported outcomes (PROs) were based on improving or remaining in the best (i.e., maintaining high) function quintile compared to baseline status. Optimal thresholds predicting improved/high function were investigated using classification trees for the legacy federal guideline metric requiring 150 minutes/week of moderate-vigorous (MV) activity in bouts lasting 10 minutes or more (MV-bout) and other metrics (total MV, sedentary, light intensity activity, nonsedentary minutes/week). Results: Optimal thresholds based on total MV minutes/week predicted improved/high function outcomes more strongly than the legacy or other investigated metrics. Meeting the 45 total MV minutes/week threshold had increased relative risk (RR) for improved/high function (gait speed RR 1.8, 95% confidence interval [95% CI] 1.6, 2.1 and PRO physical function RR 1.4, 95% CI 1.3, 1.6) compared to less active adults. Thresholds were consistent across sex, body mass index, knee osteoarthritis status, and age. Conclusion: These results supported a physical activity minimum threshold of 45 total MV minutes/week to promote improved or sustained high function for adults with lower-extremity joint symptoms. This evidence-based threshold is less rigorous than federal guidelines (≥150 MV-bout minutes/week) and provides an intermediate goal towards the federal guideline for adults with lower-extremity symptoms.

Original languageEnglish (US)
Pages (from-to)475-483
Number of pages9
JournalArthritis Care and Research
Volume69
Issue number4
DOIs
StatePublished - Apr 1 2017

Fingerprint

Lower Extremity
Guidelines
Joints
Confidence Intervals
Knee Osteoarthritis
Arthralgia
Osteoarthritis
Body Mass Index
Light
Walking Speed
Patient Reported Outcome Measures

ASJC Scopus subject areas

  • Rheumatology

Cite this

Dunlop, D. D., Song, J., Lee, J., Gilbert, A. L., Semanik, P. A., Ehrlich-Jones, L., ... Chang, R. W. (2017). Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms. Arthritis Care and Research, 69(4), 475-483. https://doi.org/10.1002/acr.23181

Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms. / Dunlop, Dorothy D.; Song, Jing; Lee, Jungwha; Gilbert, Abigail L.; Semanik, Pamela A.; Ehrlich-Jones, Linda; Pellegrini, Christine A.; Pinto, Daniel; Ainsworth, Barbara; Chang, Rowland W.

In: Arthritis Care and Research, Vol. 69, No. 4, 01.04.2017, p. 475-483.

Research output: Contribution to journalArticle

Dunlop, DD, Song, J, Lee, J, Gilbert, AL, Semanik, PA, Ehrlich-Jones, L, Pellegrini, CA, Pinto, D, Ainsworth, B & Chang, RW 2017, 'Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms', Arthritis Care and Research, vol. 69, no. 4, pp. 475-483. https://doi.org/10.1002/acr.23181
Dunlop, Dorothy D. ; Song, Jing ; Lee, Jungwha ; Gilbert, Abigail L. ; Semanik, Pamela A. ; Ehrlich-Jones, Linda ; Pellegrini, Christine A. ; Pinto, Daniel ; Ainsworth, Barbara ; Chang, Rowland W. / Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms. In: Arthritis Care and Research. 2017 ; Vol. 69, No. 4. pp. 475-483.
@article{fcc2473035174c40a29985e373569290,
title = "Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms",
abstract = "Objective: To identify an evidence-based minimum physical activity threshold to predict improved or sustained high function for adults with lower-extremity joint symptoms. Methods: Prospective multisite data from 1,629 adults, age ≥49 years with symptomatic lower-extremity joint pain/aching/stiffness, participating in the Osteoarthritis Initiative accelerometer monitoring substudy were clinically assessed 2 years apart. Improved/high function in 2-year gait speed and patient-reported outcomes (PROs) were based on improving or remaining in the best (i.e., maintaining high) function quintile compared to baseline status. Optimal thresholds predicting improved/high function were investigated using classification trees for the legacy federal guideline metric requiring 150 minutes/week of moderate-vigorous (MV) activity in bouts lasting 10 minutes or more (MV-bout) and other metrics (total MV, sedentary, light intensity activity, nonsedentary minutes/week). Results: Optimal thresholds based on total MV minutes/week predicted improved/high function outcomes more strongly than the legacy or other investigated metrics. Meeting the 45 total MV minutes/week threshold had increased relative risk (RR) for improved/high function (gait speed RR 1.8, 95{\%} confidence interval [95{\%} CI] 1.6, 2.1 and PRO physical function RR 1.4, 95{\%} CI 1.3, 1.6) compared to less active adults. Thresholds were consistent across sex, body mass index, knee osteoarthritis status, and age. Conclusion: These results supported a physical activity minimum threshold of 45 total MV minutes/week to promote improved or sustained high function for adults with lower-extremity joint symptoms. This evidence-based threshold is less rigorous than federal guidelines (≥150 MV-bout minutes/week) and provides an intermediate goal towards the federal guideline for adults with lower-extremity symptoms.",
author = "Dunlop, {Dorothy D.} and Jing Song and Jungwha Lee and Gilbert, {Abigail L.} and Semanik, {Pamela A.} and Linda Ehrlich-Jones and Pellegrini, {Christine A.} and Daniel Pinto and Barbara Ainsworth and Chang, {Rowland W.}",
year = "2017",
month = "4",
day = "1",
doi = "10.1002/acr.23181",
language = "English (US)",
volume = "69",
pages = "475--483",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "John Wiley and Sons Ltd",
number = "4",

}

TY - JOUR

T1 - Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms

AU - Dunlop, Dorothy D.

AU - Song, Jing

AU - Lee, Jungwha

AU - Gilbert, Abigail L.

AU - Semanik, Pamela A.

AU - Ehrlich-Jones, Linda

AU - Pellegrini, Christine A.

AU - Pinto, Daniel

AU - Ainsworth, Barbara

AU - Chang, Rowland W.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Objective: To identify an evidence-based minimum physical activity threshold to predict improved or sustained high function for adults with lower-extremity joint symptoms. Methods: Prospective multisite data from 1,629 adults, age ≥49 years with symptomatic lower-extremity joint pain/aching/stiffness, participating in the Osteoarthritis Initiative accelerometer monitoring substudy were clinically assessed 2 years apart. Improved/high function in 2-year gait speed and patient-reported outcomes (PROs) were based on improving or remaining in the best (i.e., maintaining high) function quintile compared to baseline status. Optimal thresholds predicting improved/high function were investigated using classification trees for the legacy federal guideline metric requiring 150 minutes/week of moderate-vigorous (MV) activity in bouts lasting 10 minutes or more (MV-bout) and other metrics (total MV, sedentary, light intensity activity, nonsedentary minutes/week). Results: Optimal thresholds based on total MV minutes/week predicted improved/high function outcomes more strongly than the legacy or other investigated metrics. Meeting the 45 total MV minutes/week threshold had increased relative risk (RR) for improved/high function (gait speed RR 1.8, 95% confidence interval [95% CI] 1.6, 2.1 and PRO physical function RR 1.4, 95% CI 1.3, 1.6) compared to less active adults. Thresholds were consistent across sex, body mass index, knee osteoarthritis status, and age. Conclusion: These results supported a physical activity minimum threshold of 45 total MV minutes/week to promote improved or sustained high function for adults with lower-extremity joint symptoms. This evidence-based threshold is less rigorous than federal guidelines (≥150 MV-bout minutes/week) and provides an intermediate goal towards the federal guideline for adults with lower-extremity symptoms.

AB - Objective: To identify an evidence-based minimum physical activity threshold to predict improved or sustained high function for adults with lower-extremity joint symptoms. Methods: Prospective multisite data from 1,629 adults, age ≥49 years with symptomatic lower-extremity joint pain/aching/stiffness, participating in the Osteoarthritis Initiative accelerometer monitoring substudy were clinically assessed 2 years apart. Improved/high function in 2-year gait speed and patient-reported outcomes (PROs) were based on improving or remaining in the best (i.e., maintaining high) function quintile compared to baseline status. Optimal thresholds predicting improved/high function were investigated using classification trees for the legacy federal guideline metric requiring 150 minutes/week of moderate-vigorous (MV) activity in bouts lasting 10 minutes or more (MV-bout) and other metrics (total MV, sedentary, light intensity activity, nonsedentary minutes/week). Results: Optimal thresholds based on total MV minutes/week predicted improved/high function outcomes more strongly than the legacy or other investigated metrics. Meeting the 45 total MV minutes/week threshold had increased relative risk (RR) for improved/high function (gait speed RR 1.8, 95% confidence interval [95% CI] 1.6, 2.1 and PRO physical function RR 1.4, 95% CI 1.3, 1.6) compared to less active adults. Thresholds were consistent across sex, body mass index, knee osteoarthritis status, and age. Conclusion: These results supported a physical activity minimum threshold of 45 total MV minutes/week to promote improved or sustained high function for adults with lower-extremity joint symptoms. This evidence-based threshold is less rigorous than federal guidelines (≥150 MV-bout minutes/week) and provides an intermediate goal towards the federal guideline for adults with lower-extremity symptoms.

UR - http://www.scopus.com/inward/record.url?scp=85014284265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014284265&partnerID=8YFLogxK

U2 - 10.1002/acr.23181

DO - 10.1002/acr.23181

M3 - Article

VL - 69

SP - 475

EP - 483

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

SN - 2326-5191

IS - 4

ER -