Document Detail

Do activity levels increase after total hip and knee arthroplasty?
MedLine Citation:
PMID:  24353051     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: People with osteoarthritis (OA) often are physically inactive. Surgical treatment including total hip arthroplasty or total knee arthroplasty can substantially improve pain, physical function, and quality of life. However, their impact on physical activity levels is less clear.
QUESTIONS/PURPOSES: We used accelerometers to measure levels of physical activity pre- and (6 months) postarthroplasty and to examine the proportion of people meeting the American Physical Activity Guidelines.
METHODS: Sixty-three people with hip or knee OA awaiting arthroplasty were recruited from a major metropolitan hospital. Physical activity was measured using accelerometry before, and 6 months after, surgery. The ActiGraph GT1M (ActiGraph LLC, Fort Walton Beach, FL, USA) was used in this study and is a uniaxial accelerometer contained within a small activity monitor designed to measure human movement through changes in acceleration, which can then be used to estimate physical activity over time. Questionnaires were used to assess patient-reported changes in pain, function, quality of life, and physical activity. Complete data sets (including valid physical activity data) for both time points were obtained for 44 participants (70%). At baseline before arthroplasty, the activity level of patients was, on average, sedentary for 82% of the time over a 24-hour period (based on accelerometry) and self-rated as "sometimes participates in mild activities such as walking, limited shopping, and housework" according to the UCLA activity scale.
RESULTS: There was no change in objectively measured physical activity after arthroplasty. The majority of participants were sedentary, both before and after arthroplasty, and did not meet the American Physical Activity Guidelines recommended to promote health. This was despite significant improvements in self-reported measures of pain, function, quality of life, and physical activity after arthroplasty.
CONCLUSIONS: Despite patient-reported improvements in pain, function, and physical activity after arthroplasty, objectively measured improvements in physical activity may not occur. Clinicians should incorporate strategies for improving physical activity into their management of patients after hip and knee arthroplasty to maximize health status. Future research is needed to explore the factors that impact physical activity levels in people after arthroplasty.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Paula Harding; Anne E Holland; Clare Delany; Rana S Hinman
Publication Detail:
Type:  Journal Article     Date:  2013-12-19
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  472     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-04-01     Completed Date:  2014-06-02     Revised Date:  2014-09-15    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1502-11     Citation Subset:  AIM; IM    
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MeSH Terms
Actigraphy / instrumentation
Activities of Daily Living
Aged, 80 and over
Arthroplasty, Replacement, Hip / adverse effects
Arthroplasty, Replacement, Knee / adverse effects
Biomechanical Phenomena
Equipment Design
Health Status
Hip Joint / physiopathology,  surgery*
Knee Joint / physiopathology,  surgery*
Middle Aged
Motor Activity*
Osteoarthritis, Hip / diagnosis,  physiopathology,  surgery*
Osteoarthritis, Knee / diagnosis,  physiopathology,  surgery*
Pain, Postoperative / etiology
Prospective Studies
Quality of Life
Recovery of Function
Sedentary Lifestyle
Time Factors
Treatment Outcome
Comment In:
Clin Orthop Relat Res. 2014 Sep;472(9):2891-2   [PMID:  24962495 ]
Clin Orthop Relat Res. 2014 Sep;472(9):2889-90   [PMID:  24964888 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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