A Randomized Study of Exercise and Fitness Trackers in Obese Patients After Total Knee Arthroplasty

Objective To synthesize evidence on physical activity interventions that used wearables, either alone or in combination with education or rehabilitation, in adults following orthopaedic surgical procedures. Methods PubMed, CINAHL, PsycINFO and EMBASE were searched for randomized controlled trials of wearable-based interventions from each database’s inception to August 2021 in patients undergoing orthopaedic surgery. Relevant outcomes included physical activity, physical function, pain, psychological distress, or general health. PEDro scale scoring ranges from 0 to 10 and was used to appraise studies as high (≥7), moderate (5–6), or poor (<5) quality. Results Of 335 articles identified, 6 articles met eligibility criteria. PEDro scores ranged from 2 to 6, with 3 studies of moderate quality and 3 of poor quality. Studies included patients undergoing total knee (number; n = 4) or total knee or hip (n = 1) arthroplasty and lumbar disc herniation surgery (n = 1). In addition to wearables, intervention components included step diary (n = 2), motivational interviewing (n = 1), goal setting (n = 2), tailored exercise program (n = 2), or financial incentives (n = 1). Interventions were delivered in-person (n = 2), remotely (n = 3) or in a hybrid format (n = 1). Intervention duration ranged from 6 weeks to 6 months. Compared to controls, 3 moderate quality studies reported greater improvement in steps/day; however, 1 moderate and 2 poor quality studies showed no between-group difference in physical function, pain, or quality of life. No serious adverse events related to the use of wearable were reported. Conclusions The effects of physical activity interventions using wearables, either delivered in-person or remotely, appear promising for increasing steps per day after joint arthroplasty; however, this finding should be viewed with caution since it is based on 3 moderate quality studies. Further research is needed to determine the therapeutic effects of using wearables as an intervention component in patients undergoing other orthopaedic surgical procedures. Trial registration PROSPERO Registration Number: CRD42020186103

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“…The samples included a total of 263 men and 305 women. Four (67%) studies were conducted in the United States [ 34 – 37 ].…”

Section: Resultsmentioning

confidence: 99%

Effects of physical activity interventions using wearables to improve objectively-measured and patient-reported outcomes in adults following orthopaedic surgical procedures: A systematic review

et al. 2022

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“…There were 64 (57%) studies that had mentioned exercise adherence within their study [ 18 , 19 , 22 – 24 , 27 , 29 , 31 , 33 , 34 , 36 – 38 , 42 – 47 , 50 , 53 , 54 , 58 , 59 , 63 , 65 – 69 , 73 , 74 , 78 , 79 , 82 – 84 , 86 , 90 – 93 , 96 – 100 , 102 – 104 , 107 – 109 , 111 , 112 , 114 , 117 , 118 , 121 , 123 , 126 , 127 , 129 , 131 ]. Of these studies only 41 (65%) reported sufficient information (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…Of these studies only 41 (65%) reported sufficient information (e.g. measurement used and outcome) to assess exercise adherence [ 19 , 22 , 31 , 33 , 34 , 36 , 38 , 42 – 45 , 53 , 58 , 66 – 68 , 74 , 78 , 79 , 82 , 83 , 86 , 90 – 93 , 96 – 98 , 102 – 104 , 107 – 109 , 112 , 114 , 117 , 123 , 126 , 127 ]. There were 15 studies that had a pre-defined cut-off for exercise adherence (see Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…There were no RCTs that fulfilled all 16 items (total score of 19) of the CERT (See Additional file 5 : Appendix E for the completion of the CERT for each included study). There were 18 RCTs that reported at least 14 (74%) items intervention group, [ 19 , 22 , 31 , 38 , 45 , 58 , 74 , 77 , 78 , 82 , 86 , 90 , 97 , 107 , 117 , 123 , 127 ] and 9 RCTs in the control group [ 19 , 22 , 31 , 38 , 45 , 74 , 78 , 108 , 117 ]. Frequency and percentage of adequately reported CERT items are presented in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

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Reporting of post-operative rehabilitation interventions for Total knee arthroplasty: a scoping review

Bakaa

Chen

Carlesso

et al. 2021

BMC Musculoskelet Disord

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Objective The aim of this study was to evaluate the completeness of reporting of exercise adherence and exercise interventions delivered as part of clinical trials of post-operative total knee replacement (TKA) rehabilitation. Design: Scoping review Literature search A literature search was conducted in PubMed, EMBASE, AMED, CINAHL, SPORTDiscus and Cochrane Library. Study selection criteria All randomized controlled trials (RCT) that examined post-operative exercise-based interventions for total knee arthroplasty were eligible for inclusion. Studies that were multifactorial or contained exercise interventions for both hip and knee arthroplasty were also included. Data synthesis The definition, type of measurement used and outcome for exercise adherence were collected and analyzed descreptively. Quality of reporting of exercise interventions were assessed using the Consensus for Exercise Reporting Tool (CERT) and the Cochrane Risk of Bias Tool. Results There were a total of 112 RCTs included in this review. The majority of RCTs (63%, n = 71) did not report exercise adherence. Only 23% (n = 15) of studies provided a definition of adherence. RCTs were of poor quality, with 85% (n = 95) of studies having high or unclear risk of bias. Reporting of exercise interventions was poor, with only 4 items (of 19) (21%) of the CERT adequately reported (88–99%), with other items not fulfilled on at least 60% of the RCTs. There were no RCTs that had fulfilled all the criteria for the CERT. Conclusion The RCTs included in this study poorly reported exercise adherence, as well as description of the post-operative TKA rehabilitation intervention. Future RCTs should use valid and reliable measures of adherence and a proper tool for reporting of exercise interventions (e.g., CERT, TiDER). Pre-registration OSF:https://osf.io/9ku8a/

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“…In a review study by Goh et al, it was shown that exercise programs could reduce pain and improve the performance of patients with KOA (21). In addition, in a study by Smith et al, performing exercise programs could improve the performance and QOL of patients with total knee arthroplasty (TKA) (51). In line with the present study, the findings of a study by Cai et al demonstrated that cognitive-behavioral therapy (CBT) implementation, which was one of the materials trained in this intervention, could enhance knee function, reduce pain, and reduce kinesiophobia in patients with TKA (52), besides diminishing depression (52); these findings are consistent with those obtained in the current study.…”

Section: Discussionmentioning

confidence: 99%

Effect of Self-Management Program on Pain and Disability Index in Elderly Men with Osteoarthritis

et al. 2019

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Background: Osteoarthritis (OA) is a progressive disease of the joints, leading to decreased function and disability. Objectives: The study aimed to investigate the effect of self-management (SM) program on disability index and pain in aging men with knee OA. Methods: The study included an SM group and a control group. Given the sample size of the previous studies, 83 patients were recruited. The study tools included a demographic profile questionnaire, visual analogue scale (VAS), and HAQ 8-item DI. The intervention included 10 SM sessions for patients in the SM group (8 sessions of in-person intervention and 2 sessions of telephone intervention). Patients were placed in groups of 7, and the sessions were held weekly each for a period of 45 to 60 minutes. Data were analyzed using descriptive and analytical tests by SPSS V. 16 software. Results: The two groups(SM and control group) were homogeneous in terms of demographic characteristics (P > 0.05). The mean (SD) disability score was 19.12 (1.92) in the SM group before the intervention, which reduced to 14.70 (1.63) after the intervention (P = 0.000, T = 10.02). The mean (SD) pain score, was 9.19 (0.71) in the SM group before the intervention, which reduced to 6.48 (0.84) after the intervention (P = 0.000, T = 18.15). Conclusions: Training can help patients perform SM measures and improve their health status by enhancing the information needed for the disease.

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A Randomized Study of Exercise and Fitness Trackers in Obese Patients After Total Knee Arthroplasty

Cited by 12 publications

References 31 publications

Effects of physical activity interventions using wearables to improve objectively-measured and patient-reported outcomes in adults following orthopaedic surgical procedures: A systematic review

Effects of physical activity interventions using wearables to improve objectively-measured and patient-reported outcomes in adults following orthopaedic surgical procedures: A systematic review

Reporting of post-operative rehabilitation interventions for Total knee arthroplasty: a scoping review

Effect of Self-Management Program on Pain and Disability Index in Elderly Men with Osteoarthritis

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