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Research ArticleArticle

Association of Physical Activity with Late-life Mobility Limitation among Women with Total Joint Replacement for Knee or Hip Osteoarthritis

Aladdin H. Shadyab, Charles B. Eaton, Wenjun Li and Andrea Z. LaCroix
The Journal of Rheumatology June 2018, jrheum.171136; DOI: https://doi.org/10.3899/jrheum.171136
Aladdin H. Shadyab
From the Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, California; Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. Supported by the US National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant T32 AR064194 to AHS), the US National Heart, Lung, and Blood Institute (contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C), and the Women’s Health Center of Excellence at the University of California, San Diego School of Medicine. The National Heart, Lung, and Blood Institute has representation on the Women’s Health Initiative Steering Committee, which governed the design and conduct of the study, the interpretation of the data, and preparation and approval of manuscripts. A.H. Shadyab, PhD, Postdoctoral Fellow, Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine; C.B. Eaton, MD, MS, Professor, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Department of Family Medicine, Warren Alpert Medical School, Brown University; W. Li, PhD, Associate Professor, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School; A.Z. LaCroix, PhD, Professor, Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine. Address correspondence to Dr. A.H. Shadyab, Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0725, La Jolla, California 92093, USA. E-mail: aladdinhs@yahoo.com. Accepted for publication February 13, 2018.
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Charles B. Eaton
From the Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, California; Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. Supported by the US National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant T32 AR064194 to AHS), the US National Heart, Lung, and Blood Institute (contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C), and the Women’s Health Center of Excellence at the University of California, San Diego School of Medicine. The National Heart, Lung, and Blood Institute has representation on the Women’s Health Initiative Steering Committee, which governed the design and conduct of the study, the interpretation of the data, and preparation and approval of manuscripts. A.H. Shadyab, PhD, Postdoctoral Fellow, Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine; C.B. Eaton, MD, MS, Professor, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Department of Family Medicine, Warren Alpert Medical School, Brown University; W. Li, PhD, Associate Professor, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School; A.Z. LaCroix, PhD, Professor, Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine. Address correspondence to Dr. A.H. Shadyab, Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0725, La Jolla, California 92093, USA. E-mail: aladdinhs@yahoo.com. Accepted for publication February 13, 2018.
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Wenjun Li
From the Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, California; Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. Supported by the US National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant T32 AR064194 to AHS), the US National Heart, Lung, and Blood Institute (contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C), and the Women’s Health Center of Excellence at the University of California, San Diego School of Medicine. The National Heart, Lung, and Blood Institute has representation on the Women’s Health Initiative Steering Committee, which governed the design and conduct of the study, the interpretation of the data, and preparation and approval of manuscripts. A.H. Shadyab, PhD, Postdoctoral Fellow, Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine; C.B. Eaton, MD, MS, Professor, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Department of Family Medicine, Warren Alpert Medical School, Brown University; W. Li, PhD, Associate Professor, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School; A.Z. LaCroix, PhD, Professor, Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine. Address correspondence to Dr. A.H. Shadyab, Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0725, La Jolla, California 92093, USA. E-mail: aladdinhs@yahoo.com. Accepted for publication February 13, 2018.
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Andrea Z. LaCroix
From the Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, California; Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. Supported by the US National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant T32 AR064194 to AHS), the US National Heart, Lung, and Blood Institute (contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C), and the Women’s Health Center of Excellence at the University of California, San Diego School of Medicine. The National Heart, Lung, and Blood Institute has representation on the Women’s Health Initiative Steering Committee, which governed the design and conduct of the study, the interpretation of the data, and preparation and approval of manuscripts. A.H. Shadyab, PhD, Postdoctoral Fellow, Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine; C.B. Eaton, MD, MS, Professor, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Department of Family Medicine, Warren Alpert Medical School, Brown University; W. Li, PhD, Associate Professor, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School; A.Z. LaCroix, PhD, Professor, Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine. Address correspondence to Dr. A.H. Shadyab, Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive #0725, La Jolla, California 92093, USA. E-mail: aladdinhs@yahoo.com. Accepted for publication February 13, 2018.
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Abstract

Objective To examine the association between leisure-time physical activity (PA) and survival to age 85 with mobility limitation or death before age 85 after total knee (TKR) or total hip replacement (THR) for osteoarthritis (OA).

Methods This was a prospective study among participants from the Women’s Health Initiative (WHI), recruited 1993–1998 (baseline age 65–79 yrs) and followed through 2012. Medicare claims data were linked to WHI data to determine TKR (n = 1986) and THR (n = 1034). Self-reported PA was collected before total joint replacement (TJR).

Results Women who were physically inactive before THR had the highest risk of mobility limitation at age 85 (OR 2.36, 95% CI 1.30–4.26) compared with women who had the highest amount of PA [> 17.42 metabolic equivalent of task (MET)-hrs/week]. Women who reported no moderate to vigorous PA (MVPA) before THR had the strongest risk of mobility limitation (OR 2.00, 95% CI 1.24–3.22) compared with women with the highest level of MPVA (≥ 15 MET-hrs/week). Women who were physically inactive before TKR had the highest risk of mobility limitation (OR 1.68, 95% CI 1.15–2.45) compared with women who had the highest PA level. Women who reported no MVPA before TKR had the strongest risk of mobility limitation (OR 1.60, 95% CI 1.16–2.19) compared with women with the highest level of MPVA. There were significant dose-response associations of lower PA levels with increased risk of late-life mobility limitation and death.

Conclusion Women with lower PA levels before TJR were more likely to experience mobility limitation in late life following TJR for hip or knee OA.

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Association of Physical Activity with Late-life Mobility Limitation among Women with Total Joint Replacement for Knee or Hip Osteoarthritis
Aladdin H. Shadyab, Charles B. Eaton, Wenjun Li, Andrea Z. LaCroix
The Journal of Rheumatology Jun 2018, jrheum.171136; DOI: 10.3899/jrheum.171136

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Association of Physical Activity with Late-life Mobility Limitation among Women with Total Joint Replacement for Knee or Hip Osteoarthritis
Aladdin H. Shadyab, Charles B. Eaton, Wenjun Li, Andrea Z. LaCroix
The Journal of Rheumatology Jun 2018, jrheum.171136; DOI: 10.3899/jrheum.171136
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