Predicting physical activity recovery after hip and knee arthroplasty? A longitudinal cohort study

Abstract

Background: Recovery of physical activity (PA) after telerehabilitation following knee and hip arthroplasty (TKA-THA) has rarely been studied. An improved understanding of PA recovery is needed, as it could be influenced by many factors such as age, gender or pre-operative physical function.Objectives: To assess PA recovery weekly for 3 months after TKA-THA and to determine perioperative factors that could help predict PA recovery at 3 months. Methods: From one week before until 3 months after surgery, 132 patients wore a fitness tracker continuously. Each patient received personalized and daily exercises and feedback through a tablet. Before and after surgery, patient-reported outcome measures of symptoms, pain, activities of daily living and quality of life were recorded. A one-way repeated-measure ANOVA was used to assess the time effect on step count for each post-operative week. To predict the absolute step count at 3 months post-surgery, a backward multiple linear regression was used. Results: Patients reached their pre-operative PA level at week 7, with no significant additional improvement by 3 months post-surgery. Pre-operative step count, the number of days using crutches and pre-operative symptoms explained 35% of the variability of step count at 3 months. Conclusion: This patient population receiving telerehabilitation reached their pre-operative PA level at 7-week post-surgery with no further improvement over the subsequent 5 weeks. The PA level at 3 months could be predicted by pre-operative step count, duration of crutches use, and pre-operative symptoms.

Process of Posthospital Care Involving Telemedicine Solutions for Patients after Total Hip Arthroplasty

“…Technological developments combining fitness trackers and tablet use are promising for providing telerehabilitation and for monitoring daily activity [ 41 ].…”

Injuries Associated with Crutch Use: A Narrative Review

“…10 There is wide variability in the clinical literature on what defines an "acute" versus a "chronic" injury or condition. 11 As such, in determining duration of crutch use, short-term injuries were designated as those that occurred within and including 4 weeks of using crutches, as most individuals using crutches for acute musculoskeletal injuries 12 or surgeries [13][14][15] use these devices for less than 4 weeks. Long-term crutch use was specified as greater than or equal to 1 year of use, as it was anticipated that by this time their injury or impairment would have stabilized and patients would have developed a consistent assisted gait pattern.…”

A Systematic Review of the Use of Commercial Wearable Activity Trackers for Monitoring Recovery in Individuals Undergoing Total Hip Replacement Surgery

“…Data were either uploaded via Bluetooth or submitted by the patients. In several studies, the wearable activity monitors' data was claimed to be reliable and valid for the assessment of step count due to previous documents [29][30][31][32][33].…”

“…In one study, the feedback group received a daily step goal (7000 steps by week 6) and was allowed to see the number of steps, while the other group did not [29]. Lebleu et al [31] prescribed personalised, daily exercises, and feedback through a tablet. Patients in the study of Goeb et al [39] were instructed to avoid the "leg-shaving position" as a postoperative precaution.…”

“…The study is judged to be at low or moderate risk of bias for all domains. Lebleu et al [31] ROBINS-I Moderate risk of bias The study is judged to be at low or moderate risk of bias for all domains.…”