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Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative

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Abstract

Higher levels of moderate to vigorous physical activity improve all-cause mortality and cardiovascular events. However, the effect of running, a moderate to vigorous activity, in those with knee osteoarthritis (OA), a common arthritis that occurs with aging, a high-risk group for mortality and cardiovascular events, is unclear. Therefore, we aimed to evaluate the association of self-selected running on OA symptom and structure progression in people with knee OA. This nested cohort study within the Osteoarthritis Initiative (OAI) (2004–2014) included those at least 50 years old with OA in at least one knee. Runners were defined using a self-administered questionnaire at the 96-month visit. At baseline and 48-months, symptoms were assessed and radiographs were scored for Kellgren-Lawrence (KL) grade (2–4) and medial Joint Space Narrowing (JSN) score (0–3). We evaluated the association of self-selected running with outcomes: KL worsening, medial JSN worsening, new knee pain, and improved knee pain over 48 months, adjusting for baseline age, sex, body mass index (BMI), KL score, contralateral KL score, contralateral knee pain, and injury. If data were not available at the 48-month visit, then they were imputed from the 36-month visit. One thousand two hundred three participants had a mean age of 63.2 (7.9) years, BMI of 29.5 (4.6) kg/m2, 45.3% male, and 11.5% runners. Data from 8% of participants required imputation. Adjusted odds ratios for KL grade worsening and new frequent knee pain were 0.9 (0.6–1.3) and 0.9 (0.6–1.6) respectively. Adjusted odds ratio for frequent knee pain resolution was 1.7 (1.0–2.8). Among individuals 50 years old and older with knee OA, self-selected running is associated with improved knee pain and not with worsening knee pain or radiographically defined structural progression. Therefore, self-selected running, which is likely influenced by knee symptoms and may result in lower intensity and shorter duration sessions of exercise, need not be discouraged in people with knee OA.

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Funding

Dr. Lo is supported by K23 AR062127, an NIH/NIAMS funded mentored award, providing support for design and conduct of the study, analysis, and interpretation of the data; and preparation and review of this work. Dr. Suarez-Almazor is supported by K24 AR053593, funded by NIH/NIAMS. This work is supported in part with resources at the VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413), at the Michael E. DeBakey VA Medical Center, Houston, TX. The Osteoarthritis Initiative is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the Osteoarthritis Initiative Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the Osteoarthritis Initiative is managed by the Foundation for the National Institutes of Health.

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Authors and Affiliations

  1. Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA

    Grace H. Lo, Sarra M. Musa & Nancy J. Petersen

  2. Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, TX, USA

    Grace H. Lo

  3. Division of Rheumatology, Tufts Medical Center, Boston, MA, USA

    Jeffrey B. Driban & Timothy E. McAlindon

  4. Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA

    Andrea M. Kriska

  5. Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA

    Richard B. Souza

  6. Department of Kinesiology, Health and Sport Science, Indiana University of Pennsylvania, Indiana, PA, USA

    Kristi L. Storti

  7. Department of Family Medicine and Epidemiology, Memorial Hospital of Rhode Island and Alpert Medical School of Brown University, Pawtucket, RI, USA

    Charles B. Eaton

  8. Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA

    Marc C. Hochberg

  9. Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, OH, USA

    Rebecca D. Jackson

  10. University of Arizona Arthritis Center, University of Arizona, Tucson, AZ, USA

    C. Kent Kwoh

  11. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA

    Michael C. Nevitt

  12. Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Maria E. Suarez-Almazor

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  1. Grace H. Lo
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  2. Sarra M. Musa
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  3. Jeffrey B. Driban
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  6. Richard B. Souza
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  7. Nancy J. Petersen
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  8. Kristi L. Storti
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  9. Charles B. Eaton
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  10. Marc C. Hochberg
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  11. Rebecca D. Jackson
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  14. Maria E. Suarez-Almazor
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Correspondence to Grace H. Lo.

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The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institutes of Health, or the Department of Veterans Affairs.

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Lo, G.H., Musa, S.M., Driban, J.B. et al. Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clin Rheumatol 37, 2497–2504 (2018). https://doi.org/10.1007/s10067-018-4121-3

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  • DOI: https://doi.org/10.1007/s10067-018-4121-3

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