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Patient-specific reference values for objective physical function tests: data from the Osteoarthritis Initiative

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Abstract

Introduction/objective

We aimed to establish sex-specific reference values of objective physical function tests among individuals with or at risk for knee osteoarthritis (KOA) across subsets of age, radiographic KOA severity, and body mass index (BMI).

Method

We included Osteoarthritis Initiative participants with data for objective physical function tests, sex, age, BMI, and radiographic KOA severity (Kellgren-Lawrence [KL] grade) at baseline. Objective physical function was quantified with 20-m walk speed, chair-stand speed, 400-m walk time, and knee extension and flexion strength. We created participant characteristic subsets for sex, age, KL grade, and BMI. Reference values were created as percentiles from minimum to maximum in 10% increments for each combination of participant characteristic subsets. Previously established clinically important differences for 20-m walk speed and knee extension strength were used to highlight clinically relevant differences.

Results

Objective physical function reference values tables and an interactive reference value table were created across all combinations of sex, age, KL grade, and BMI among 3860 individuals with or at risk for KOA. Clinically relevant differences exist for 20-m walk speed and knee extension strength between males and females across age groups, KL grades, and BMI categories.

Conclusions

Establishing an individual’s relative level of objective physical function by comparing their performance to individuals with similar sex, age, KL grade, or BMI may help improve interpretation of physical function performance. The interactive reference value table will provide clinicians and researchers a clinically accessible avenue to use these reference values.

Key Points

• Since greater age, radiographic knee osteoarthritis severity, and body mass index are all associated with worse objective physical function, reference values should consider the complex inter-play among these patient characteristics.

• This study provides objective physical function reference values among subsets of individuals across the spectrum of sex, age groups, radiographic knee osteoarthritis severity, and body mass index categories.

• These reference values offer a more patient-centered approach for interpreting an individual’s relative level of objective physical function by comparing them to a more homogeneous group of individuals with similar participant characteristics.

• We have provided a clinically accessible interactive table that will enable clinicians and researchers to input their patient’s data to quickly and efficiently determine a patient’s relative objective physical function compared to individual’s with similar characteristics.

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Funding

MSH was supported by the National Institutes of Health (grant no. 5 TL1 TR 1454-3). These data were financially supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (grant no. R01 AR065977). The OAI 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 OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the NIH, or the private funding partners. This research was based upon work supported by the U.S. Department of Agriculture, under agreement no. 58-1950-4-003. Any opinions, findings, conclusion, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture.

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Authors and Affiliations

  1. Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA

    Matthew S. Harkey, Lucas Ogura Dantas, Timothy E. McAlindon & Jeffrey B. Driban

  2. Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

    Matthew S. Harkey, Shao-Hsien Liu & Kate L. Lapane

  3. The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA

    Lori Lyn Price

  4. Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA

    Lori Lyn Price

  5. Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA

    Kieran F. Reid

  6. Medical Care Line and Research Care Line, Houston Health Services Research and Development Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA

    Grace H. Lo

  7. Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA

    Grace H. Lo

  8. Physical Therapy Department, Neuromuscular Plasticity Laboratory, Federal University of São Carlos, São Paulo, Brazil

    Lucas Ogura Dantas

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  1. Matthew S. Harkey
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  2. Lori Lyn Price
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Correspondence to Matthew S. Harkey.

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Harkey, M.S., Price, L.L., Reid, K.F. et al. Patient-specific reference values for objective physical function tests: data from the Osteoarthritis Initiative. Clin Rheumatol 39, 1961–1970 (2020). https://doi.org/10.1007/s10067-020-04972-1

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