Risk of Knee Osteoarthritis Over 24 Months in Individuals Who Decrease Walking Speed During a 12-Month Period: Data from the Osteoarthritis Initiative.

Objective: To assess the association between change in walking speed over a 12-month period and risk of developing radiographic knee osteoarthritis (rKOA) over a 24-month period.

Methods: We included participants without rKOA from the Osteoarthritis Initiative. Change in walking speed was determined from a 20-m walk assessment, calculated using walking speed at 12-month followup minus baseline speed and/or 24-month followup walking speed minus 12-month speed. Incident rKOA was defined as progressing to Kellgren-Lawrence arthritis grading scale ≥ 2 within 24 months (i.e., incidence between 12 and 36 mos or 24 and 48 mos). Self-reported significant knee injury during the exposure period, age, body mass index (BMI), and Physical Activity Scale for the Elderly (PASE) score were adjusted for analytically.

Results: We included 2638 observations among 1460 unique participants (58% women; aged 59 ± 9 yrs, range 45-79). The mean change in walking speed over 12 months was 0.001 ± 0.13 m/s (range -0.6271 to 1.4968). About 5% of the sample (n = 122) developed rKOA over a 24-month period. After controlling for significant knee injury, age, BMI, and PASE score, we found an 8% relative increase in risk of developing rKOA for every 0.1 m/s decrease in walking speed over a 12-month period (risk ratio 1.08, 95% CI 1.00-1.15, p = 0.05).

Conclusion: Evaluating change in speed over a 12-month period using a 20-m walk test may be useful in identifying individuals at increased risk of developing rKOA over the subsequent 24 months. Identification of patients at high risk for developing rKOA would allow medical providers to implement early interventions to maximize joint health.