Association of walking cadence to changes in knee pain and physical function: The multicenter osteoarthritis study

Determine the association of walking cadence to incident and worsening knee pain and physical function over 2 years in adults with or at risk for knee OA.

Participants from the Multicenter Osteoarthritis study were included.Cadence was measured using a GAITRite walkway. Incident and worsening knee symptoms, pain with walking, and functional limitations were assessed at baseline and 2 years later. The association of cadence to each outcome was analyzed using log binomial regression. Cadence was assessed continuously as a 10-unit change and categorically using quartiles. Analyses were adjusted for age, sex, race, BMI, presence of tibiofemoral OA, depression, and history of knee injury. Sensitivity analyses were conducted for all outcomes adjusted for gait speed and stratified by sex.

Among 1600 participants (60.3 ​% female, age 67.1 ​± ​7.7 years), lower cadence was not significantly associated with incident or worsening knee symptoms, pain with walking, or functional limitations. For every 10-step/min decrease in cadence, the risk of incident knee symptoms increased by 10 ​% (RR ​= ​1.10, 95%CI [0.97, 1.25]), though this was not statistically significant and was attenuated after adjusting for gait speed (RR ​= ​0.95, 95%CI [0.80, 1.12]). No significant associations were observed for incident or worsening pain with walking or functional limitations. Sex-stratified analyses revealed inconsistent findings, including an increased risk for incident functional limitations in females (RR ​= ​1.45, 95%CI [1.02, 2.08]), which was attenuated after adjusting for gait speed.

Lower cadence was not significantly associated with pain and function, suggesting that the interplay between cadence, gait speed, and clinical outcomes warrants further investigation.