Dataset Information

Activity levels and participation in physical activities by Korean patients following total knee arthroplasty.

ABSTRACT:

Background

The objectives of this study were to describe changes in physical activity profiles of Korean patients after TKA and to determine whether the postoperative physical activity level is influenced by patient socio-demographic factors and postoperative functional outcomes. We also sought to determine whether regular postoperative physical activity is associated with greater patient satisfaction after TKA.

Methods

This observational study included 369 patients. Physical activity profiles before and after TKA were evaluated using a questionnaire that contained the UCLA activity scale and types of sports activities. The associations of socio-demographic features and postoperative functional outcomes with the physical activity levels were assessed using subgroup comparisons and partial correlation analyses. In addition, the effects of regular physical activity on patient satisfaction with replaced knees were evaluated using subgroup comparisons.

Results

Walking, swimming and bicycling were the three most common sports activities both before and after TKA. After TKA, the mean activity level remained similar (UCLA score = 4.5 before TKA vs. 4.8 after TKA); however, the frequency of moderate activity levels (UCLA scale, 4-6) and moderate types of physical activities increased. Patients with higher postoperative function scores reported higher postoperative activity levels, but socio-demographic factors were not associated with activity level. Regular physical activity was associated with greater patient satisfaction.

Conclusions

This study provides valuable information about realistic expectations for physical activity after TKA. Regular participation in physical activity should be encouraged to improve patient satisfaction.

SUBMITTER: Chang MJ

PROVIDER: S-EPMC4108970 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

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Publications

Activity levels and participation in physical activities by Korean patients following total knee arthroplasty.

Chang Moon Jong MJ Kim Sung Hee SH Kang Yeon Gwi YG Chang Chong Bum CB Kim Tae Kyun TK

BMC musculoskeletal disorders 20140717

<h4>Background</h4>The objectives of this study were to describe changes in physical activity profiles of Korean patients after TKA and to determine whether the postoperative physical activity level is influenced by patient socio-demographic factors and postoperative functional outcomes. We also sought to determine whether regular postoperative physical activity is associated with greater patient satisfaction after TKA.<h4>Methods</h4>This observational study included 369 patients. Physical acti ...[more]

PMID: 25030804

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Project description:BackgroundAfter total knee arthroplasty (TKA), patients' physical activity (PA) levels at 6 months are lower than those of healthy subjects. Few studies have investigated the factors associated with PA at 6 months after TKA by objectively measuring preoperative and postoperative PA intensity using an accelerometer and knee function using a goniometer and dynamometer. The purpose of this study was to determine the factors associated with PA levels at 6 months after TKA based on objective data.MethodsEighty-two patients (mean [SD] age 74.5 [6.4] years) with moderate-to-severe knee osteoarthritis (OA) who were scheduled for TKA at the Nagoya Orthopaedic and Joint Replacement Clinic from July 2018 to July 2019 were enrolled in this longitudinal study. All patients underwent evaluations of knee function, including range-of-motion and knee-extension muscle strength; knee pain; performance in the timed up-and-go test; and accelerometer-measured PA both preoperatively and 6 months postoperatively. Factors associated with PA at 6 months after TKA were assessed using a hierarchical multiple linear regression analysis adjusted for age, sex, body mass index, and presence of diabetes mellitus.ResultsA higher average daily step count at 6 months after TKA was significantly associated with greater preoperative knee-extension muscle strength on the operated side (β = 0.155, p = 0.028) as well as a higher preoperative average daily step count (β = 0.834, p < 0.001). Furthermore, average daily time spent in moderate-to-vigorous-intensity PA postoperatively was significantly associated only with time spent in moderate-to-vigorous-intensity PA preoperatively (β = 0.723, p < 0.001).ConclusionThese findings indicate that a higher preoperative daily step count and greater preoperative knee-extension muscle strength on the operated side may be associated with a higher daily step count at 6 months after TKA. Factors associated with PA differed by the PA intensity level. Rehabilitation and interventions for psychosocial factors before TKA beginning when mild knee OA first occurs are expected to lead to increased PA in TKA patients.

Project description:ContextTotal knee arthroplasty (TKA) is routinely performed in younger patients who desire to be active in fitness and recreational sports. The activities patients can participate in without symptoms and the level of aerobic fitness routinely maintained are important to investigate.ObjectiveTo determine physical activity (PA) and recreational sports resumed after primary TKA, symptoms or limitations with these activities, and the effect of postoperative rehabilitation on achieving fitness and sports goals.Data sourcesA systematic review of the literature from 2005 through 2015 was conducted using the PubMed database.Study selectionOriginal investigations that were conducted at least 1 year after primary TKA and reported the percentage of patients who returned to recreational activities or routinely participated in aerobic PA recommended by the American Heart Association (AHA) were included in this study.Study designSystematic review.Level of evidenceLevel 4.Data extractionData were extracted as available from 19 eligible studies. Assessment of study quality was rated using the MINORS (Methodological Index for Non-Randomized Studies) instrument.ResultsThere were 5179 knees (mean age, 67.5 years) followed for a mean 4.8 years postoperatively. Marked variability was present between studies regarding the percentage of patients who resumed recreational activities (34%-100%), most of which were low impact. Only 2 studies used accelerometers to measure PA; these reported a low range (0%-16.5%) of patients who met AHA guidelines. Few studies determined whether symptoms or limitations were experienced during PA. None described rehabilitation exercises or factors that would influence patients' ability to return to recreational or fitness activities.ConclusionLittle evidence is available regarding the effect of TKA on return to recreational and (objectively measured) aerobic fitness. The extent of symptoms or limitations during PA and the long-term effects of such problems remain unclear. Valid predictions cannot be made on factors that may affect return to recreational sports or other aerobic PA after TKA.

Project description:BackgroundFew instruments that measure physical activity (PA) can accurately quantify PA performed at light and moderate intensities, which is particularly relevant in older adults. The evidence of their reliability in free-living conditions is limited.ObjectiveThe study objectives were: (1) to determine the test-retest reliability of the Actigraph (ACT), SenseWear Armband (SWA), and Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire in assessing free-living PA at light and moderate intensities in people after total knee arthroplasty; (2) to compare the reliability of the 3 instruments relative to each other; and (3) to determine the reliability of commonly used monitoring time frames (24 hours, waking hours, and 10 hours from awakening).DesignA one-group, repeated-measures design was used.MethodsParticipants wore the activity monitors for 2 weeks, and the CHAMPS questionnaire was completed at the end of each week. Test-retest reliability was determined by using the intraclass correlation coefficient (ICC [2,k]) to compare PA measures from one week with those from the other week.ResultsData from 28 participants who reported similar PA during the 2 weeks were included in the analysis. The mean age of these participants was 69 years (SD=8), and 75% of them were women. Reliability ranged from moderate to excellent for the ACT (ICC=.75-.86) and was excellent for the SWA (ICC=.93-.95) and the CHAMPS questionnaire (ICC=.86-.92). The 95% confidence intervals (95% CI) of the ICCs from the SWA were the only ones within the excellent reliability range (.85-.98). The CHAMPS questionnaire showed systematic bias, with less PA being reported in week 2. The reliability of PA measures in the waking-hour time frame was comparable to that in the 24-hour time frame and reflected most PA performed during this period.LimitationsReliability may be lower for time intervals longer than 1 week.ConclusionsAll PA measures showed good reliability. The reliability of the ACT was lower than those of the SWA and the CHAMPS questionnaire. The SWA provided more precise reliability estimates. Wearing PA monitors during waking hours provided sufficiently reliable measures and can reduce the burden on people wearing them.

Project description:Background and objectivesKnee osteoarthritis is one of the primary causes of chronic pain among older adults and because of the aging population, the number of total knee arthroplasties (TKAs) performed is exponentially increasing. While pain reduction is a goal of TKA, movement-evoked pain is rarely assessed pre- and post-TKA. We characterized the distributions of change in pain, function, and situational catastrophizing in patients from presurgery to 3 months postsurgery and explored associations among these pre-post changes.Research design and methodsThis prospective study longitudinally assessed movement-evoked pain, function, and situational catastrophizing in patients with knee osteoarthritis (N = 92) using in-person performance-based tests (6-min walk test [6MWT], stair-climb test [SCT]) prior to and 3 months after TKA. Patients also completed the Western Ontario McMaster Universities Scales (WOMAC) pain and function subscales, and Pain Catastrophizing Scale, presurgery and 3- and 6-months postsurgery.ResultsMovement-evoked pain and function on performance tests significantly improved from pre- to post-TKA. Improved SCT function was associated with reduced SCT pain and catastrophizing. Similarly, reduced pain during the SCT was associated with reduced catastrophizing during the SCT. However, 6MWT function was not associated with 6MWT pain or catastrophizing; yet reduced pain during the 6MWT was associated with reduced catastrophizing during the 6MWT. Reduced movement-evoked pain during both performance tests was consistently associated with improved WOMAC function and pain, whereas improved function on performance tests was inconsistently associated with WOMAC function and pain. Notably, greater movement-evoked pain on both performance tests at 3-month post-TKA was associated with worse WOMAC function and pain at 6 months, whereas better function on performance tests at 3 months was associated with better WOMAC function, but not related to WOMAC pain at 6 months.Discussion and implicationsFindings highlight the importance of situation-specific and in vivo assessments of pain and catastrophizing during physical activity.

Dataset Information

Activity levels and participation in physical activities by Korean patients following total knee arthroplasty.

Background

Methods

Results

Conclusions

Publications

Activity levels and participation in physical activities by Korean patients following total knee arthroplasty.

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