Researchers determine knee OA thresholds for rehab referral

WASHINGTON — Researchers at the University of Delaware have determined the minimum workout thresholds for patients with knee osteoarthritis that would determine whether a patient should be referred to physical rehabilitation, according to a presentation at the American College of Rheumatology Annual Meeting.

“We previously found that walking 6,000 steps per day was an important benchmark for maintaining physical health in people with knee osteoarthritis [(OA)],” Daniel White, PT, assistant professor in the Department of Physical Therapy at the University of Delaware, said in his presentation. “However, it is still unclear when doctors, rheumatologists and primary care physicians need to refer their patients with knee [(OA)] to rehabilitation.”

Daniel White

White and colleagues used public data from the Osteoarthritis Initiative, in which steps per day were recorded for 1,790 patients with an accelerometer until a 48-month follow-up visit. At follow-up, physical function was assessed with the following three tests:

speed in walking 20 meters;
time to perform a 400-meter walk; and,
time to perform five sit-to-stand tests.

The researchers calculated cut-off points at 80% specificity for walking at least 6,000 steps per day.

To have at least 80% specificity for walking 6,000 steps per day — below which represents insufficient physical function — the researchers found the following measurements:

1.25 meters per second for the 20-meter walk;
315 seconds for the 400-meter walk; and,
11 seconds for the five STS tests.

“To be honest, one of the most exciting things about the research is that getting up from a chair is something that all physicians can do in their office,” White said. “I’m a physical therapist and some physicians might be nervous about getting patients in the hallway and timing them and having them fall, but getting up from a chair is fail-safe. If they are going to fall, they will fall right back into the chair.” – by Will Offit

Reference:

White D, et al. Abstract #3253. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.

Disclosure: The researchers report no relevant financial disclosures.