Figure 1. Flowchart of participant selection. Participants were excluded sequentially for accelerometer calibration failure, insufficient wear time, implausibly high mean acceleration, missing daily MVPA data, less than one complete week of accelerometer wear, missing covariates, or prevalent OA at baseline. The final analytic cohort included 83,386 participants without OA at baseline. Abbreviations: BMI, body mass index; MVPA, moderate-to-vigorous physical activity; OA, osteoarthritis.