Improvements in Objectively Measured Activity Behaviors Do Not Correlate With Improvements in Patient-Reported Outcome Measures Following Total Knee Arthroplasty

Frimpong, Emmanuel; Jagt, D.R. van der; Mokete, Lipalo; Pietrzak, J; Kaoje, Yusuf S; Smith, Anne; McVeigh, Joanne; Meiring, Rebecca M.

doi:10.1016/j.arth.2019.10.016

Cited by 23 publications

(22 citation statements)

References 61 publications

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“…Almost 9 months after surgery, the patients in the present study reported significant and meaningful improvements in their joint-related situation, not only for pain, joint symptoms and quality of life, but also for activities of daily living, recreational activities and sport. As a result, one might have expected that this subjective rating would be confirmed by accelerometry measurements; however, this was not the case, thus confirming previous findings [ 4 ]. The patients’ PA, which was assessed by the daily number of steps, the time in MVPA and the PAEE showed no changes after THA.…”

Section: Discussionsupporting

confidence: 83%

“…Due to the increasing age of western populations and the wider adoption of a physically inactive lifestyle, a further increase in the incidence of OA can be expected [ 3 ]. Following conservative treatment, total hip arthroplasty (THA) is indicated in end-stage OA [ 4 ]. THA followed by rehabilitation usually leads to complete freedom from pain, a significant improvement of patient health related quality of life, the restoration of joint function and significant improvements in physical functioning [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Sedentary Behavior in Older Patients before and after Total Hip Arthroplasty: A Prospective Cohort Study

Moellenbeck

Horst²,

Gosheger

et al. 2020

Healthcare

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Objective: To compare the habitual sedentary behavior (SB) and physical activity (PA) of older hip osteoarthritis patients before and after elective arthroplasty. Methods: SB, PA and joint-specific disability of 16 patients (68.9 ± 6.8 years) were assessed by accelerometry and questionnaires before and 9 months after arthroplasty. Results: All patients reported substantial postoperative improvements of their joint-related complaints (p ≤ 0.001). Accelerometry showed changes in neither daily SB (10–60 min sedentary bouts, p ≥ 0.569) nor in PA (steps, time in mild-to-vigorous activity and energy expenditure, p ≥ 0.255). Correlation analyses revealed that patients with severe preoperative disability showed a decrease in sedentary time, which was the opposite in patients with mild preoperative disability. Conclusion: SB and PA do not necessarily change after arthroplasty in older orthopedic patients. Even longer bouts of uninterrupted sitting, which are detrimental to health, do not decrease. Preoperative patient education is recommended to foster behavioral changes following elective arthroplasty.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Sedentary Behavior in Older Patients before and after Total Hip Arthroplasty: A Prospective Cohort Study

Moellenbeck

Horst²,

Gosheger

et al. 2020

Healthcare

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“…After removing duplicated articles and reviewing the title and the abstract,420 articles remained. Then, four of them only met the inclusion criteria after the full text examination [20,[27][28][29] (Figure 1). Later, one of them was excluded because it was only a protocol study [27].…”

Section: Resultsmentioning

confidence: 99%

“…Frimpong et al, 2020 [29] examined 43 participants after six-months of unilateral total knee replacement surgery. The patients used the ActivPAL for seven consecutive days.…”

Section: Granat Et Al 2020mentioning

confidence: 99%

Effect of the Knee Replacement Surgery on Activity Level Based on Activpal: A Systematic Review and Meta-analysis Study

Alfatafta

Onchonga

et al. 2022

Preprint

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Background: The knee replacement (KR) surgery is done to restore the activity level and reduce the risk of experiencing disabilities. The outcomes of this surgery is evaluated mainly with subjective tools or low validity objective tools. However, the effect of the surgery on activity level using high validity objective accelerometer is still in question. Methods: A systematic review and meta-analysis were conducted to find out if the knee replacement surgery alone could enhance the physical activity based on high validity accelerometer, ActivPAL, after at least six months of the surgery. Two independent reviewers evaluated five electronic databases (Cochrane-Central-Register-of-Controlled Trials, EMBASE, PubMed, and Web of Science, and Scopus) to find relative studies between January 2000 and October 2021. The quality assessments and risk of bias assessments were examined.Results: Three articles were included with 202 participants (86 males, 116 females), with an average age of 64 years and an average 32 kg/m² body mass index. The results found that the number of steps was significantly improved up to 36.35% and 45.5% after six-months and one-year of the surgery, respectively. However, these changes did not meet the recommended activity level guideline and could be related to the patients' health status and their activity level before the surgery. No significant changes were seen in sedentary time, standing time, and upright time after six-months and one-year follow-up. Heterogeneity among studies was low to moderate (0%- 57%).Conclusion: The knee replacement surgery is an effective treatment to improve the quality of life in patients with severe knee injuries; however, to achieve the maximum benefit of the surgery the sedentary time should be reduced. Various factors have impacts on surgical success. Thus, further studies are needed to add these factors using high validity monitors.

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“…First, sedentary behavior and physical activity will be measured using two activity monitors, Actigraph and ActivPAL. Although ActivPAL may be a more accurate assessment of sedentary time due to its ability to determine posture and is recommended in other populations [ 85 ], few studies have used them with adults who received a knee replacement [ 52 , 86 , 87 ]. Another strength of the study is that participants will be enrolled in the study prior to knee replacement and will be randomized shortly after surgery.…”

Section: Discussionmentioning

confidence: 99%

Reducing sedentary time using an innovative mHealth intervention among patients with total knee replacement: Rationale and study protocol

Pellegrini

Lee

DeVivo

et al. 2021

Contemporary Clinical Trials Communications

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Introduction Although knee replacement is effective for improving pain and physical function, subsequent improvements in physical activity typically do not follow. As a result, many patients spend most of their day engaged in sedentary behavior, which may put them at higher risk of experiencing poor function and disability. Intervening on sedentary time, rather than physical activity, may be a more feasible first-step approach for modifying activity-related behaviors in adults who received knee replacement. Objective The purpose of this study is to examine the use of a mobile health (mHealth) intervention to reduce sedentary time among adults who received a knee replacement at 3 and 6 months after surgery. Methods Patients (n = 92) scheduled for knee replacement will be recruited and at 4 weeks after surgery, they will be randomized to either NEAT!2 or Control. NEAT!2 participants will use the NEAT!2 smartphone app, which provides a vibration and/or audible tone to interrupt prolonged bouts of sitting detected from the smartphone's internal accelerometer, until 3 months after surgery. NEAT!2 participants will receive biweekly coaching calls between 4 and 12 weeks after surgery. Control participants will receive an education control app and receive non-intervention calls to assess general surgery recovery. Both groups will receive 3 retention calls between 3 and 6 months. Data collection will occur pre-operatively and at 3 and 6 months after surgery. Discussion The results of this study will help to determine whether an innovative remotely-delivered, mHealth sedentary reduction intervention can decrease sedentary time in adults after knee replacement.

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Improvements in Objectively Measured Activity Behaviors Do Not Correlate With Improvements in Patient-Reported Outcome Measures Following Total Knee Arthroplasty

Cited by 23 publications

References 61 publications

Sedentary Behavior in Older Patients before and after Total Hip Arthroplasty: A Prospective Cohort Study

Sedentary Behavior in Older Patients before and after Total Hip Arthroplasty: A Prospective Cohort Study

Effect of the Knee Replacement Surgery on Activity Level Based on Activpal: A Systematic Review and Meta-analysis Study

Reducing sedentary time using an innovative mHealth intervention among patients with total knee replacement: Rationale and study protocol

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