A Home‐Based Pedometer‐Driven Walking Program to Increase Physical Activity in Older Adults with Osteoarthritis of the Knee: A Preliminary Study

Abstract

OBJECTIVES: To determine whether a home‐based pedometer‐driven walking program with arthritis self‐management education (Walk +) would increase physical activity, muscle strength, and functional performance in older adults with osteoarthritis (OA) of the knee as opposed to arthritis self‐management education alone (EDU). DESIGN: A randomized two‐by‐three (group‐by‐time) design with participants assigned to Walk + (n = 17, mean age ± standard deviation = 69.6 ± 6.7) or EDU (n = 17, age = 70.8 ± 4.7). SETTING: Community located in the Baltimore‐Washington area. PARTICIPANTS: Thirty‐four community‐dwelling adults, aged 60 and older with symptomatic knee OA and self‐reported functional impairment. INTERVENTIONS: Both groups received 12 hours of the Arthritis Self‐Management program over 12 weeks and were followed for an additional 12 weeks. In addition, the Walk + group received individualized instruction in the use of a pedometer, with the goal of increasing their step count by 30% of their baseline step count. MEASUREMENTS: The outcome measures were physical activity (daily step counts and total activity vector magnitude as measured by a pedometer and Tritrac‐R3D accelerometer), quadriceps femoris strength (isometric peak torque), and functional performance tasks (100‐foot walk‐turn‐walk, timed stair climb, timed chair rise, and pain status). RESULTS: Daily steps walked showed a significant group‐by‐time interaction (P = .04) after controlling for age. From baseline to completion of training, a 23% increase in daily steps occurred in the Walk + group and a 15% decrease in the EDU group. Although steps increased in the Walk + group, total activity vector magnitude was maintained, suggesting a more efficient gait. The Walk + group became quicker than the EDU group in the normal‐pace walk‐turn‐walk (P = .04). An isometric strength gain of 21% postintervention was seen in the Walk + group, compared with a loss of 3.5% in the EDU group. CONCLUSION: In older adults with symptomatic knee OA, Walk + appears to increase walking, with improvements in muscle strength and walking performance. The use of a home‐based pedometer‐driven program to increase physical activity, strength, and function in this population warrants further research.