Association of Low Physical Activity Levels With Gait Patterns Considered at Risk for Clinical Knee Osteoarthritis Progression

OBJECTIVE: Although gait analysis provides an estimate of joint loading magnitude and patterns during a typical step, accelerometry provides information about loading frequency. Understanding the relationships between these components of loading and knee osteoarthritis (OA) progression may improve conservative management, as gait interventions may need to account for physical activity levels or vice versa. The primary objective was to examine relationships between gait patterns that have previously been associated with OA progression and accelerometer‐derived metrics of loading frequency. The secondary objective examined the association of accelerometer‐derived metrics and total knee arthroplasty (TKA) at a mean follow‐up of 3.5 years. METHODS: Fifty‐seven individuals with knee OA underwent gait analysis and 1 week of accelerometer wear. Spearman correlations were calculated between accelerometer‐derived metrics and gait patterns. Differences across quartiles of step count were examined with Jonckheere‐Terpstra tests. In a subsample, baseline differences between TKA and no TKA groups were examined with Mann‐Whitney U‐tests. RESULTS: Gait variables previously related to progression were correlated to both step count and moderate‐ to vigorous‐intensity, but not lower‐intensity, physical activity. Individuals in the lowest quartile (~4000 steps/day) exhibited gait patterns previously related to progression. There were no differences in any baseline accelerometer‐derived metrics between those that did and did not undergo TKA at follow‐up. CONCLUSION: Complex relationships exist between gait, physical activity, and OA progression. Accelerometer‐derived metrics may contribute unique information about overall loading for individuals above a certain activity threshold, but for those with lower activity levels, gait may be sufficient to predict clinical progression risk, at least over the short term.