Diabetes is Associated with Longitudinal Declined Physical Performance Measures in Persons with or at Risk of Knee Osteoarthritis: Data from the Osteoarthritis Initiative

Overview

Journal Eur J Phys Rehabil Med

Specialty Rehabilitation Medicine

Date 2024 Apr 22

PMID 38647532

Authors

Aqeel M Alenazi

Bader A Alqahtani

Affiliations

Soon will be listed here.

Abstract

Background: The primary aim of this study was to longitudinally examine the impact of diabetes mellitus (DM) on physical performance measures including Gait Speed and Chair Stand tests over 8 years of follow-up in people with or at risk of knee osteoarthritis (OA).

Design: A prospective longitudinal study.

Setting: Multisite community based.

Population: This study included participants with or at risk of knee OA aged from 45 to 79 years from the Osteoarthritis Initiative from baseline to 96 months follow-up.

Methods: The participants performed physical performance measures using a 20 m Walk Test for Gait Speed and 5 Times Sit To Stand for repeated chair stand test time at baseline and during follow-up visits. Participants were asked about the presence of diabetes mellitus (DM) at baseline and categorized into with or without DM. Generalized estimating equations were utilized with 2 models, one for DM and Gait Speed and the other for DM and Repeated Chair Stand Test after controlling for covariates including age, sex, education, Body Mass Index (BMI), depressive symptoms, physical activity level, baseline number of comorbidities, and baseline Kellgren and Lawrence grades for OA grading for each knee.

Results: A total of 4796 participants were included and categorized into those with DM (N.=362) and without DM (N.=4311) at baseline. Participants with DM at baseline showed significantly declined gait speed (B=-0.048, 95% Confidence Interval [95% CI]: [-0.07, -0.02], P<0.001) and significantly an increased time for repeated chair stand test (B=0.49, 95% CI: [0.08, 0.89], P=0.018) over time when compared to those without DM at baseline, after controlling for covariates.

Conclusions: DM was associated with negative impact on Gait Speed and Repeated Chair Stand Test time in individuals with or at risk of knee OA. Individuals with knee OA and diabetes who exhibit declining physical performance measures are at risk of functional dependence, reduced quality of life, and complex rehabilitation requirements.

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References

Alenazi A, Alshehri M, Alothman S, Alqahtani B, Rucker J, Sharma N . The Association of Diabetes with Knee Pain Severity and Distribution in People with Knee Osteoarthritis using Data from the Osteoarthritis Initiative. Sci Rep. 2020; 10(1):3985. PMC: 7055209. DOI: 10.1038/s41598-020-60989-1. View

Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H . Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 2021; 29-30:100587. PMC: 7704420. DOI: 10.1016/j.eclinm.2020.100587. View

Washburn R, Smith K, Jette A, Janney C . The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993; 46(2):153-62. DOI: 10.1016/0895-4356(93)90053-4. View

Munoz-Bermejo L, Adsuar J, Mendoza-Munoz M, Barrios-Fernandez S, Garcia-Gordillo M, Perez-Gomez J . Test-Retest Reliability of Five Times Sit to Stand Test (FTSST) in Adults: A Systematic Review and Meta-Analysis. Biology (Basel). 2021; 10(6). PMC: 8228261. DOI: 10.3390/biology10060510. View

Shin D . Association between metabolic syndrome, radiographic knee osteoarthritis, and intensity of knee pain: results of a national survey. J Clin Endocrinol Metab. 2014; 99(9):3177-83. DOI: 10.1210/jc.2014-1043. View

Reeuwijk K, de Rooij M, van Dijk G, Veenhof C, Steultjens M, Dekker J . Osteoarthritis of the hip or knee: which coexisting disorders are disabling?. Clin Rheumatol. 2010; 29(7):739-47. PMC: 2878451. DOI: 10.1007/s10067-010-1392-8. View

Vinik A, Maser R, Mitchell B, Freeman R . Diabetic autonomic neuropathy. Diabetes Care. 2003; 26(5):1553-79. DOI: 10.2337/diacare.26.5.1553. View

Herzog M, Driban J, Cattano N, Cameron K, Tourville T, Marshall S . Risk of Knee Osteoarthritis Over 24 Months in Individuals Who Decrease Walking Speed During a 12-Month Period: Data from the Osteoarthritis Initiative. J Rheumatol. 2017; 44(8):1265-1270. PMC: 6061917. DOI: 10.3899/jrheum.170093. View

Yates T, Zaccardi F, Dhalwani N, Davies M, Bakrania K, Celis-Morales C . Association of walking pace and handgrip strength with all-cause, cardiovascular, and cancer mortality: a UK Biobank observational study. Eur Heart J. 2017; 38(43):3232-3240. PMC: 5837337. DOI: 10.1093/eurheartj/ehx449. View

10.

Lord S, Murray S, Chapman K, Munro B, Tiedemann A . Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. J Gerontol A Biol Sci Med Sci. 2002; 57(8):M539-43. DOI: 10.1093/gerona/57.8.m539. View

11.

Louati K, Vidal C, Berenbaum F, Sellam J . Association between diabetes mellitus and osteoarthritis: systematic literature review and meta-analysis. RMD Open. 2015; 1(1):e000077. PMC: 4613158. DOI: 10.1136/rmdopen-2015-000077. View

12.

Eitner A, Pester J, Vogel F, Marintschev I, Lehmann T, Hofmann G . Pain sensation in human osteoarthritic knee joints is strongly enhanced by diabetes mellitus. Pain. 2017; 158(9):1743-1753. DOI: 10.1097/j.pain.0000000000000972. View

13.

Bohannon R, Glenney S . Minimal clinically important difference for change in comfortable gait speed of adults with pathology: a systematic review. J Eval Clin Pract. 2014; 20(4):295-300. DOI: 10.1111/jep.12158. View

14.

Cho K, Bok S, Kim Y, Hwang S . Effect of lower limb strength on falls and balance of the elderly. Ann Rehabil Med. 2012; 36(3):386-93. PMC: 3400879. DOI: 10.5535/arm.2012.36.3.386. View

15.

Alenazi A, Alothman S, Alshehri M, Rucker J, Waitman L, Wick J . The prevalence of type 2 diabetes and associated risk factors with generalized osteoarthritis: a retrospective study using ICD codes for clinical data repository system. Clin Rheumatol. 2019; 38(12):3539-3547. DOI: 10.1007/s10067-019-04712-0. View

16.

Williams M, London D, Husni E, Navaneethan S, Kashyap S . Type 2 diabetes and osteoarthritis: a systematic review and meta-analysis. J Diabetes Complications. 2016; 30(5):944-50. DOI: 10.1016/j.jdiacomp.2016.02.016. View

17.

Park S, Goodpaster B, Lee J, Kuller L, Boudreau R, de Rekeneire N . Excessive loss of skeletal muscle mass in older adults with type 2 diabetes. Diabetes Care. 2009; 32(11):1993-7. PMC: 2768193. DOI: 10.2337/dc09-0264. View

18.

Nomura T, Kawae T, Kataoka H, Ikeda Y . Aging, physical activity, and diabetic complications related to loss of muscle strength in patients with type 2 diabetes. Phys Ther Res. 2019; 21(2):33-38. PMC: 6336454. DOI: 10.1298/ptr.R0002. View

19.

Wilson R, Blakely T, Abbott J . Radiographic knee osteoarthritis impacts multiple dimensions of health-related quality of life: data from the Osteoarthritis Initiative. Rheumatology (Oxford). 2018; 57(5):891-899. PMC: 6251551. DOI: 10.1093/rheumatology/key008. View

20.

Alenazi A, Alqahtani B, Vennu V, Alshehri M, Alanazi A, Alrawaili S . Gait Speed as a Predictor for Diabetes Incidence in People with or at Risk of Knee Osteoarthritis: A Longitudinal Analysis from the Osteoarthritis Initiative. Int J Environ Res Public Health. 2021; 18(9). PMC: 8122394. DOI: 10.3390/ijerph18094414. View