Webber S1, Barclay R1, Ripat J2, Tate R3
1University of Manitoba, Physical Therapy, Winnipeg, Canada, 2University of Manitoba, Occupational Therapy, Winnipeg, Canada, 3University of Manitoba, Community Health Sciences, Winnipeg, Canada
Background: Community ambulation and social participation are positively associated with health-related quality of life in older adults. Limitations in the ability to walk in the community can lead to reduced social participation, decline in self-care abilities, depression and social isolation. People with osteoarthritis (OA) affecting the knee and/or hip often report difficulty walking outdoors. In this population, the presence of walking disability is associated with higher levels of all-cause mortality, as well as cardiovascular and dementia-related mortality compared to those who do not report difficulty with walking.
Purpose: To identify factors associated with community ambulation and social participation in Canadians 45-85 years of age with OA.
Methods: We analyzed data from the Canadian Longitudinal Study on Aging Tracking group Main Wave and Maintaining Contact questionnaires. Multivariable logistic regression models were developed for community ambulation and social participation in people with OA in one or both knees and/or hips. Explanatory variables were chosen based on a review of related literature. Number of chronic conditions, education, marital status, province and urban/rural factors were controlled.
Results: Our model for community ambulation included 3808 individuals with OA. Individuals with OA were more likely to walk outdoors “sometimes or often” (vs. “never or seldom”) in good weather months (e.g., July vs. January: OR 2.21; CI 1.57, 3.11) and if they were in younger age groups (e.g., 55-64 years vs. 75-85 years: OR 1.53; 1.22, 1.92). Factors associated with being less likely to walk outdoors included: poor vs. excellent self-rated health (OR 0.55; 0.34, 0.90), difficulty walking 2-3 blocks vs. no difficulty (OR 0.59; 0.48, 0.74), severe pain vs. no pain (OR 0.63; 0.47, 0.85), and female vs. male (OR 0.79; 0.66-0.94).
Our model for social participation included 4370 people with OA. Individuals were more likely to participate in social activities “weekly or daily” (vs. “never/yearly/monthly”) if they were female vs. male (OR 1.40; 1.13, 1.72). They were less likely to participate regularly if they were unable to walk 2-3 blocks vs. no difficulty (OR 0.44; 0.27, 0.72), if they were more dissatisfied with their life (e.g., extremely dissatisfied vs. extremely satisfied: OR 0.31; 0.18, 0.54), and if they were younger (e.g., 45-54 years of age vs. 75-85; OR 0.69; 0.49, 0.98).
Conclusion(s): A number of factors influence community ambulation and social participation in people with OA. The effects of age and sex differ for the two outcomes. The ability to walk 2-3 blocks was positively associated with both models.
Implications: Findings underscore the importance of walking ability in influencing both community ambulation and social participation in people with OA affecting the knee and/or hip. Physical therapists should address gait abnormalities and walking tolerance (including community ambulation) in this population to improve health-related quality of life and reduce risks of mortality.
Keywords: rehabilitation, participation, walking
Funding acknowledgements: This work was funded by an Endowment Grant from the College of Rehabilitation Sciences at the University of Manitoba.
Purpose: To identify factors associated with community ambulation and social participation in Canadians 45-85 years of age with OA.
Methods: We analyzed data from the Canadian Longitudinal Study on Aging Tracking group Main Wave and Maintaining Contact questionnaires. Multivariable logistic regression models were developed for community ambulation and social participation in people with OA in one or both knees and/or hips. Explanatory variables were chosen based on a review of related literature. Number of chronic conditions, education, marital status, province and urban/rural factors were controlled.
Results: Our model for community ambulation included 3808 individuals with OA. Individuals with OA were more likely to walk outdoors “sometimes or often” (vs. “never or seldom”) in good weather months (e.g., July vs. January: OR 2.21; CI 1.57, 3.11) and if they were in younger age groups (e.g., 55-64 years vs. 75-85 years: OR 1.53; 1.22, 1.92). Factors associated with being less likely to walk outdoors included: poor vs. excellent self-rated health (OR 0.55; 0.34, 0.90), difficulty walking 2-3 blocks vs. no difficulty (OR 0.59; 0.48, 0.74), severe pain vs. no pain (OR 0.63; 0.47, 0.85), and female vs. male (OR 0.79; 0.66-0.94).
Our model for social participation included 4370 people with OA. Individuals were more likely to participate in social activities “weekly or daily” (vs. “never/yearly/monthly”) if they were female vs. male (OR 1.40; 1.13, 1.72). They were less likely to participate regularly if they were unable to walk 2-3 blocks vs. no difficulty (OR 0.44; 0.27, 0.72), if they were more dissatisfied with their life (e.g., extremely dissatisfied vs. extremely satisfied: OR 0.31; 0.18, 0.54), and if they were younger (e.g., 45-54 years of age vs. 75-85; OR 0.69; 0.49, 0.98).
Conclusion(s): A number of factors influence community ambulation and social participation in people with OA. The effects of age and sex differ for the two outcomes. The ability to walk 2-3 blocks was positively associated with both models.
Implications: Findings underscore the importance of walking ability in influencing both community ambulation and social participation in people with OA affecting the knee and/or hip. Physical therapists should address gait abnormalities and walking tolerance (including community ambulation) in this population to improve health-related quality of life and reduce risks of mortality.
Keywords: rehabilitation, participation, walking
Funding acknowledgements: This work was funded by an Endowment Grant from the College of Rehabilitation Sciences at the University of Manitoba.
Topic: Older people; Rheumatology
Ethics approval required: Yes
Institution: University of Manitoba
Ethics committee: Health Research Ethics Board
Ethics number: HS19757 – H2016:198
All authors, affiliations and abstracts have been published as submitted.
