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Is step rate associated with worsening of patellofemoral and tibiofemoral joint osteoarthritis in women and men? The Multicenter Osteoarthritis Study

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posted on 2020-11-13, 03:44 authored by Harvi HartHarvi Hart, K Douglas Gross, Kay CrossleyKay Crossley, Christian BartonChristian Barton, David T Felson, Ali Guermazi, Frank Roemer, Neil A Segal, Cora E Lewis, Michael C Nevitt, Joshua J Stefanik
© 2019, American College of Rheumatology

This is the peer reviewed version of the following article: Step Rate and Worsening of Patellofemoral and Tibiofemoral Joint Osteoarthritis in Women and Men: The Multicenter Osteoarthritis Study, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Objective: To determine the association of self-selected walking step rate with worsening of cartilage damage in the patellofemoral (PF) joint and tibiofemoral (TF) joint compartments at a 2-year follow-up visit. Methods: The Multicenter Osteoarthritis Study (MOST) is a prospective cohort of men and women with or at risk of knee osteoarthritis. Self-selected step rate was measured using an instrumented GAITRite walkway (CIR Systems) at the 60-month visit. Cartilage damage was semiquantitatively graded on magnetic resonance images at the 60- and 84-month visits in the medial and lateral PF and TF compartments. Step rate was divided into quartiles, and logistic regression was used to determine the association of step rate with the risk of worsening cartilage damage in men and women separately. Analyses were adjusted for age, body mass index, and knee injury/surgery. Results: A total of 1,089 participants were included. Mean ± SD age was 66.9 ± 7.5 years, mean ± SD body mass index was 29.6 ± 4.7 kg/m2, and 62.3% of the participants were women. Women with the lowest step rate had increased risk of lateral PF (risk ratio [RR] 2.1 [95% confidence interval (95% CI) 1.1–3.8]) and TF (RR 1.8 [95% CI 1.1–2.9]) cartilage damage worsening 2 years later compared to those with the highest step rate. Men with the lowest step rate had increased risk of medial TF cartilage damage worsening 2 years later (RR 2.1 [95% CI 1.1–3.9]). Conclusion: Lower step rate was associated with increased risk of cartilage damage worsening in the lateral PF and TF compartments in women and worsening medial TF joint damage in men. Future research is necessary to understand the influence of step rate manipulation on joint biomechanics in women and men.


The Multicenter Osteoarthritis Study is supported by the NIH (grants P60-AR-047785, UO1-AG-18820, UO1-AG-18832, UO1-AG-18947, and UO1-AG-19069). Dr. Hart's work was supported by an Australian Endeavour Research Fellowship (award 6603 2018). Dr. Stefanik's work was supported by the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases grant K23-AR-070913 and National Institute of General Medical Sciences grant U54-GM-104941).

NIH | P60-AR-047785

NIH | UO1-AG-18820

NIH | UO1-AG-18832

NIH | UO1-AG-18947

NIH | UO1-AG-19069

Australian Endeavour Research Fellowship | 6603 2018

NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases) | K23-AR-070913

NIH (National Institute of General Medical Sciences) | U54-GM-104941


Publication Date



Arthritis Care and Research






7p. (p. 107-113)


John Wiley & Sons Inc.



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