Physical activity and age-related biomechanical risk factors for knee osteoarthritis

Background: Knee osteoarthritis (OA) is a highly prevalent disease leading to mobility disability in the aged that could, in part, be initiated by age-related alterations in knee mechanics. However, if and how knee mechanics change with age remains unclear. Research question: What are the impacts of age and physical activity (PA) on biomechanical characteristics that can affect the loading environment in the knee during gait? Methods: Three groups (n = 20 each, 10 male and 10 female) of healthy adults were recruited: young (Y, 21-35 years), mid-life highly active (MHi, 55-70 years, runners), and mid-life less active (MLo, 55-70 years, low PA). Outcome measures included knee kinematics and kinetics and co-activation during gait, and knee extensor muscle torque and power collected at baseline and after a 30-minute treadmill trial to determine the impact of prolonged walking on knee function. Results: At baseline, high-velocity concentric knee extensor power was lower for MLo and MHi compared with Y, and MLo displayed greater early (6.0 +/- 5.8 mm) and peak during stance (11.3 +/- 7.8 mm) femoral anterior displacement relative to the tibia compared with Y (0.2 +/- 5.6 and 4.4 +/- 6.8 mm). Also at baseline, MLo showed equal quadriceps:hamstrings activation, while Y showed greater relative hamstrings activation during midstance. The walking bout induced substantial knee extensor fatigue (decrease in maximal torque and power) in Y and MLo, while MHi were fatigue-resistant. Significance: These results indicate that maintenance of PA in mid-life may impart small but measurable effects on knee function and biomechanics that may translate to a more stable loading environment in the knee through mid-life and thus could reduce knee OA risk long-term.