Predictors of physical activity recovery after total hip arthroplasty: a prospective observational study

Patients with High Pre-Operative Physical Activity Take Longer to Return to Baseline

“…Return to pre-operative step counts is generally achieved by six-to-nine weeks [31,33,43], though changes from baseline have varied. Some studies have reported significant increases at six months or one year in low-to-moderately active participants [27,28,45,46], with increases of generally about 1000 additional steps per day, which is similar to our observation in the low-and moderate-activity participants in this study. Others reporting objective measures with activity monitors report no significant change in PA after arthroplasty [10,29,30,47].…”

“…Tudor-Locke suggested that special populations reported 3500-5500 steps per day in adults with chronic illness, where those with osteoarthritis averaged 4086 and OA with arthroplasty 4892 [44]. Harada et al reported 5092 steps on average prior to intervention [27], while the cohort participating in a study by Moellenbeck and colleagues performed 5465 on average [29], which is similar to our finding of 5151 daily steps. Conflicting results have been suggested regarding changes following THA.…”

“…Incidental activity may be inadvertently excluded from subjective reports, questionnaires are subject to potential recall bias, and function questionnaires do not adequately capture activity [35,36]. Harada et al found that THA patients' self-reports of activity on the University of California Los Angeles Activity Scale (UCLA) as well as objectively measured activity both significantly increased post-operatively [27], while others note patients' report of physical activity was significantly larger than their objectively measured activity [24,37]. Patients blinded to the readings of wearables and asked to estimate walked distances demonstrated 69% mean error pre-operatively, and these errors increased to 93% over time [38].…”

“…However, patients who were highly active prior to surgery have reported decreased activity up to two years post-operation, while patients who were considered inactive at baseline reported significantly increased activity after THA [25,26]. Though some have reported improved PA post-operatively via objective data [27,28], others have reported decreases or insignificant changes [10,29,30]. Studies that focus on the correlation of self-reported activity or PROMs and objective measures, as collected by wearable activity monitors, suggest that subjective and objective data exhibit low-to-moderate correlations [31][32][33].…”