Do Activity Levels Increase After Total Hip and Knee Arthroplasty?

Harding, Paula; Holland, Anne E; Delany, Clare; Hinman, Rana S

doi:10.1007/s11999-013-3427-3

Cited by 190 publications

(210 citation statements)

References 35 publications

(55 reference statements)

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“…The finding that physical activity does not increase, but remains at pre-arthroplasty levels is in agreement with data from national cohorts including those from the United States of America, Australia and Germany [19,28,35]. Previous literature has attributed such limited change to a number of patient-level and service-level factors.…”

Section: Discussionsupporting

confidence: 87%

Trajectory of physical activity following total hip and knee arthroplasty: data from the English Longitudinal Study of Ageing (ELSA) cohort

Smith

Dainty

Macgregor

2017

European Journal of Physiotherapy

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Purpose: To determine the prevalence and trajectory of physical activity levels in people before and after total hip (THA) and total knee arthroplasty (TKA). Results: There was a statistically significant decrease in physical activity from the pre-arthroplasty phase to the operative-recovery phase (p<0.01), and a significant increase in physical activity from the operative-recovery phase to final follow-up (p=0.05). However, overall there was no significant change in physical activity from pre-operatively to final follow-up where prevalence altered from 8% (95% Confidence Intervals (CI): 5% to 12%) to 13% (95% CI: 9% to 18%)(p=0.15). Increasing age, male gender and greater depressive symptoms were explanatory variables associated with physical inactivity (p<0.02). Materials and Methods Conclusion:Physical activity does not increase following THA or TKA. A proportion of the arthroplasty population remain physically inactive.

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Section: Discussionsupporting

confidence: 87%

Trajectory of physical activity following total hip and knee arthroplasty: data from the English Longitudinal Study of Ageing (ELSA) cohort

Smith

Dainty

Macgregor

2017

European Journal of Physiotherapy

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“…24 Advances in technology have signaled the release of several studies using more valid and reliable objective measures of PA, but the picture related to OA remains unclear. 11,18 To date, there has been no systematic identification and synthesis of studies objectively measuring PA after THA or TKA. Therefore, the aim of this review was to systematically identify, appraise, and synthesize all available studies to determine whether objectively measured PA increases from before to after THA or TKA for OA.…”

Section: [ Research Report ]mentioning

confidence: 99%

Does Physical Activity Increase After Total Hip or Knee Arthroplasty for Osteoarthritis? A Systematic Review

Arnold¹,

Walters²,

Ferrar³

2016

J Orthop Sports Phys Ther

121

111

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® T t STUDY DESIGN: Systematic review. T t BACKGROUND: Despite improvements inself-reported symptoms and perceived functional ability after total hip arthroplasty (THA) and total knee arthroplasty (TKA), it is unclear whether changes in objectively measured physical activity (PA) occur after surgery. T t OBJECTIVE:To determine if objectively measured PA increases after THA and TKA in adults with osteoarthritis. T t METHODS:Five electronic databases were searched from inception to March 3, 2015. All study designs objectively measuring PA before and after THA or TKA were eligible, including randomized controlled trials, cohort studies, and case-control studies. Two reviewers independently screened abstracts and full texts and extracted study demographic, PA, and clinical outcome data. Standardized mean differences (SMDs) and 95% confidence intervals were calculated for accelerometer-and pedometer-derived estimates of PA. Risk of methodological bias was assessed with Critical Appraisal Skills Programme checklists. T t RESULTS:Eight studies with a total of 373 participants (238 TKA, 135 THA) were included. Findings were mixed regarding improvement in objectively measured PA at 6 months after THA (SMDs, -0.20 to 1.80) and TKA (SMDs, -0.36 to 0.63). Larger improvements from 2 studies at 1 year postsurgery were generally observed after THA (SMDs, 0.39 to 0.79) and TKA (SMDs, 0.10 to 0.85). However, at 1 year, PA levels were still considerably lower than those of healthy controls (THA SMDs, -0.25 to -0.77; TKA SMDs, -1.46 to -1.80). Risk-of-bias scores ranged from 3 to 9 out of 11 (27%-82%) for cohort studies, and from 3 to 8 out of 10 (30%-80%) for case-control studies. T t CONCLUSION:The best available evidence indicates negligible changes in PA at 6 months after THA or TKA, with limited evidence for larger changes at 1 year after surgery. In the 4 studies that reported control-group data, postoperative PA levels were still considerably less than those of healthy controls. Improved perioperative strategies to instill behavioral change are required to narrow the gap between patient-perceived functional improvement and the actual amount of PA undertaken after THA and TKA. Registered with PROSPE-RO (registration number CRD42014010155). T t LEVEL OF EVIDENCE:Therapy, level 2a.

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“…Pain associated with the physical effects of OA is the most frequently identified barrier limiting physical activity (Wilcox et al, 2006). Despite the success of surgery in reducing pain and increasing physical capacity, recent studies, including one of our own, suggest that physical activity does not necessarily change following THA or TKA (de Groot, Bussmann, Stam, and Verhaar, 2008;Harding, Holland, Delany, and Hinman, 2014;Lin et al, 2013). Clearly, clinicians need to better assist people following THA or TKA to become more physically active.…”

Section: Introductionmentioning

confidence: 99%

Physical activity perceptions and beliefs following total hip and knee arthroplasty: a qualitative study

Harding

Holland

Hinman

et al. 2014

Physiotherapy Theory and Practice

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Do Activity Levels Increase After Total Hip and Knee Arthroplasty?

Abstract: 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.

Cited by 190 publications

References 35 publications

Trajectory of physical activity following total hip and knee arthroplasty: data from the English Longitudinal Study of Ageing (ELSA) cohort

Trajectory of physical activity following total hip and knee arthroplasty: data from the English Longitudinal Study of Ageing (ELSA) cohort

Does Physical Activity Increase After Total Hip or Knee Arthroplasty for Osteoarthritis? A Systematic Review

Physical activity perceptions and beliefs following total hip and knee arthroplasty: a qualitative study

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