Home

Current Issue

Archives

Guidelines for Authors

Classified Ads

Links

Search PubMed

Subscriptions

Subscriber Registration

Guidelines for Website Users

JRheum Update Service

Contact Info

Determinants of Reduced Walking Speed in People with Musculoskeletal Pain

SALMA AYIS, SHAH EBRAHIM, SUSAN WILLIAMS, PETER JÜNI, and PAUL DIEPPE

ABSTRACT.

Objective. Maintenance of good walking speed is essential to independent living. People with musculoskeletal disease often have reduced walking speed. We investigated determinants of slower walking, other than musculoskeletal disease, that might provide valuable additional targets for therapy.

Methods. We analyzed data from the Somerset and Avon Survey of Health, a community based survey of people aged over 35 years. A total of 2703 participants who reported hip or knee pain at baseline (1994/1995) were studied, and reassessed in 2002-2003; 1696 were available for followup, and walking speed was tested in 1074. Walking speed (m/s) was used as outcome measure. Baseline characteristics, including comorbidities and socioeconomic factors, were tested for their ability to predict reduced walking speed using multiple linear regression analysis.

Results. Age, female sex, and immobility at baseline were predictive of slower walking speed. Other independent risk factors included the presence of cataract, low socioeconomic status, intermittent claudication, and other cardiovascular conditions. Having a cataract was associated with a decrease of 0.10 m/s (95% CI 0.03, 0.16). Those in social class V had a walking speed 0.22 m/s (95% CI 0.12, 0.31) slower than those in social class I.

Conclusion. Comorbidities, age, female sex, and lower socioeconomic position determine walking speed in people with joint pain. Issues such as poor vision and social-economic disadvantage may add to the effect of musculoskeletal disease, suggesting the need for a holistic approach to management of these patients. (First Release August 1 2007; J Rheumatol 2007;34:1905-12)

Key Indexing Terms:

WALKING SPEED
LIMITATIONS
LONGITUDINAL
MUSCULOSKELETAL PAIN
COMORBIDITIES
INDEPENDENT LIVING

From the Department of Social Medicine, University of Bristol, Bristol, UK; Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; and Department of Social and Preventive Medicine, Division of Clinical Epidemiology and Biostatistics, University of Berne, Berne, Switzerland.

The Somerset and Avon Survey of Health was funded by the Department of Health and South and West NHS Research and Development Directorate. The followup study was supported by the British Arthritis Research Campaign (grant D0587) and the Swiss National Science Foundation (grants 3233-066377 and 3200-066378) and by the MRC Health Services Research Collaboration.

S. Ayis, PhD; S. Williams, Research Project Administrator; P. Dieppe, MD, FRCP, Director, MRC HSRC, Department of Social Medicine, University of Bristol; S. Ebrahim, DM, FRCP, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine; P. Jüni, MD, Department of Social and Preventive Medicine, Division of Clinical Epidemiology and Biostatistics, University of Berne.

Address reprint requests to Dr. S. Ayis, Department of Social Medicine, Canynge Hall, University of Bristol, Whiteladies Road, Bristol BS8 2PR, UK. E-mail: S.Ayis@bristol.ac.uk

Accepted for publication April 26, 2007.