Advertisement

Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 7, pp 2196–2205 | Cite as

Light intensity physical activity increases and sedentary behavior decreases following total knee arthroplasty in patients with osteoarthritis

  • Emmanuel Frimpong
  • Joanne A. McVeigh
  • Dick van der Jagt
  • Lipalo Mokete
  • Yusuf S. Kaoje
  • Mohammed Tikly
  • Rebecca M. MeiringEmail author
Knee
  • 326 Downloads

Abstract

Purpose

To describe objectively measured changes in the volume and pattern of physical activity and sedentary behavior in patients undergoing total knee arthroplasty for osteoarthritis.

Methods

Physical activity and sedentary behavior were measured in patients (13 males, 76 females) with a mean age of 64 years (range 55–80) and end-stage osteoarthritis of the knee, using an accelerometer (ActiGraph GT3X+) for seven consecutive days (24 h/day) prior to, 6 weeks and 6 months after total knee arthroplasty. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), University of California Los Angeles (UCLA) Activity index and range of motion (ROM) were also assessed.

Results

Proportion of time spent in sedentary behavior decreased from baseline to 6 months (mean 70.1 vs. 64.0%; p = 0.009) and the interruptions to sedentary behavior improved between baseline and 6 months after total knee arthroplasty (mean 85.0–93.0 breaks/day, p = 0.014). Proportion of time spent in light physical activity increased from baseline to 6 months after total knee arthroplasty (29.0 vs. 34.8%; p = 0.008). There was no change in time spent in moderate to vigorous physical activity after total knee arthroplasty. WOMAC (median 71.0 vs. 4.0, p < 0.001), UCLA (median 2.0 vs. 5.0, p < 0.001) as well as ROM [median (0.0°–90.0°) vs. (0.0°–110°), p < 0.05] scores improved between baseline and 6 months after total knee arthroplasty.

Conclusion

Clinically, functional improvements in patients following total knee arthroplasty may be assessed by objectively measuring changes in low intensity activity behaviors. The use of accelerometers in this study gives new insights into activity accumulation patterns in a clinical population and highlights their use in determining a behavioral response to an intervention.

Level of evidence

II.

Keywords

Physical activity Sedentary behavior Accelerometry Knee osteoarthritis Total knee arthroplasty 

Notes

Author contributions

EF participated in conceptualization of study, development of study design, collecting data, writing of drafts, editing of drafts. JAM participated in conceptualization of study, development of study design, writing of drafts, editing of drafts. DVDJ took part in conceptualization of study, development of study design, editing of drafts. LM took part in conceptualization of study, development of study design, editing of drafts. YSK took part in development of study design, collecting data, editing of drafts. MT took part in conceptualization of study, development of study design, editing of drafts. RMM participated in conceptualization of study, development of study design, writing of drafts, editing of drafts. All authors read and approved the final manuscript.

Funding

Costs associated with this study were internally funded by the School of Physiology, Faculty of Health Sciences, University of the Witwatersrand.

Compliance with ethical standards

Conflict of interest

LM wishes to declare that he has offered consultancy services for Implantcast for the development of a new prosthesis. No money has been paid for these consultancy services. The remaining authors declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (clearance certificate number M150323) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

An informed consent was obtained from all individuals participants included in the study.

References

  1. 1.
    Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, Howell D, Kaplan D, Koopman W, Longley S, Mankin H, McShane DJ, Medsger T, Meenan R, Mikkelsen W, Moskowitz R, Murphy W, Rothschild B, Segal M, Sokoloff L, Wolfe F (1986) Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum 29:1039–1049CrossRefGoogle Scholar
  2. 2.
    Arnold JB, Walters JL, Ferrar KE (2016) Does physical activity increase after total hip or knee arthroplasty for osteoarthritis? A systematic review. J Orthop Sports Phys Ther 46:431–442CrossRefGoogle Scholar
  3. 3.
    Beenackers MA, Kamphuis CBM, Giskes K, Brug J, Kunst AE, Burdorf A, van Lenthe FJ (2012) Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: a systematic review. Int J Behav Nutr Phys Act 9:116CrossRefGoogle Scholar
  4. 4.
  5. 5.
    Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P (2012) What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2:e000435CrossRefGoogle Scholar
  6. 6.
    Bradshaw D, Steyn K (2001) Poverty and chronic disease in South Africa: Medical Research Council. http://www.mrc.ac.za/bod/povertyfinal.pdf. Accessed 20 May 2017
  7. 7.
    Brandes M, Ringling M, Winter C, Hillmann A, Rosenbaum D (2011) Changes in physical activity and health-related quality of life during the first year after total knee arthroplasty. Arthritis Care Res 63:328–334Google Scholar
  8. 8.
    Chaput J-P, Carson V, Gray CE, Tremblay MS (2014) Importance of all movement behaviors in a 24 h period for overall health. Int J Environ Res Public Health 11:12575–12581CrossRefGoogle Scholar
  9. 9.
    Chastin SFM, Palarea-Albaladejo J, Dontje ML, Skelton DA (2015) Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: a novel compositional data analysis approach. PLOS One 10:e0139984CrossRefGoogle Scholar
  10. 10.
    Choi L, Liu Z, Matthews CE, Buchowski MS (2011) Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc 43:357–364CrossRefGoogle Scholar
  11. 11.
    Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster J-Y (2004) Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 86-A:963–974CrossRefGoogle Scholar
  12. 12.
    Finger JD, Tylleskär T, Lampert T, Mensink GBM (2012) Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98). BMC Public Health 12:1079CrossRefGoogle Scholar
  13. 13.
    Focht BC, Garver MJ, Devor ST, Dials J, Lucas AR, Emery CF, Hackshaw KV, Rejeski WJ (2014) Group-mediated physical activity promotion and mobility in sedentary patients with knee osteoarthritis: results from the IMPACT-pilot trial. J Rheumatol 41:2068–2077CrossRefGoogle Scholar
  14. 14.
    Freedson PS, Melanson E, Sirard J (1998) Calibration of the computer science and applications, Inc. accelerometer. Med Sci Sports Exerc 30:777–781CrossRefGoogle Scholar
  15. 15.
    Groot IB de, Bussmann HJ, Stam HJ, Verhaar JA (2008) Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthop Relat Res 466:2201CrossRefGoogle Scholar
  16. 16.
    Guthold R, Ono T, Strong KL, Chatterji S, Morabia A (2008) Worldwide variability in physical inactivity a 51-country survey. Am J Prev Med 34:486–494CrossRefGoogle Scholar
  17. 17.
    Hammett T, Simonian A, Austin M, Butler R, Allen KD, Ledbetter L, Goode AP (2017) Changes in physical activity after total hip or knee arthroplasty: a systematic review and meta-analysis of 6 and 12 months outcomes. Arthritis Care Res.  https://doi.org/10.1002/acr.23415 Google Scholar
  18. 18.
    Harding P, Holland AE, Delany C, Hinman RS (2014) Do activity levels increase after total hip and knee arthroplasty? Clin Orthop Relat Res 472:1502–1511CrossRefGoogle Scholar
  19. 19.
    Herbolsheimer F, Schaap LA, Edwards MH, Maggi S, Otero Á, Timmermans EJ, Denkinger MD, van der Pas S, Dekker J, Cooper C, Dennison EM, van Schoor NM, Peter R, Eposa Study Group (2016) Physical activity patterns among older adults with and without knee osteoarthritis in six European countries. Arthritis Care Res 68:228–236CrossRefGoogle Scholar
  20. 20.
    Jones CA, Beaupre LA, Johnston DWC, Suarez-Almazor ME (2007) Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheum Dis Clin N Am 33:71–86CrossRefGoogle Scholar
  21. 21.
    Katzmarzyk PT, Mason C (2009) The physical activity transition. J Phys Act Health 6:269–280CrossRefGoogle Scholar
  22. 22.
    Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502CrossRefGoogle Scholar
  23. 23.
    Lee J, Chang RW, Ehrlich-Jones L, Kwoh CK, Nevitt M, Semanik PA, Sharma L, Sohn M-W, Song J, Dunlop DD (2015) Sedentary behavior and physical function: objective evidence from the osteoarthritis initiative. Arthritis Care Res 67:366–373CrossRefGoogle Scholar
  24. 24.
    Lützner C, Kirschner S, Lützner J (2014) Patient activity after TKA depends on patient-specific parameters. Clin Orthop Relat Res 472:3933–3940CrossRefGoogle Scholar
  25. 25.
    Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, Troiano RP (2008) Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol 167:875–881CrossRefGoogle Scholar
  26. 26.
    Matthews CE, Hagströmer M, Pober DM, Bowles HR (2012) Best practices for using physical activity monitors in population-based research. Med Sci Sports Exerc 44:S68CrossRefGoogle Scholar
  27. 27.
    McVeigh JA, Winkler EAH, Healy GN, Slater J, Eastwood PR, Straker LM (2016) Validity of an automated algorithm to identify waking and in-bed wear time in hip-worn accelerometer data collected with a 24 h wear protocol in young adults. Physiol Meas 37:1636CrossRefGoogle Scholar
  28. 28.
    Meier W, Mizner RL, Marcus RL, Dibble LE, Peters C, Lastayo PC (2008) Total knee arthroplasty: muscle impairments, functional limitations, and recommended rehabilitation approaches. J Orthop Sports Phys Ther 38:246–256CrossRefGoogle Scholar
  29. 29.
    Meiring RM, Frimpong E, Mokete L, Pietrzak J, Van Der Jagt D, Tikly M, McVeigh JA (2016) Rationale, design and protocol of a longitudinal study assessing the effect of total knee arthroplasty on habitual physical activity and sedentary behavior in adults with osteoarthritis. BMC Musculoskelet Disord 17:281CrossRefGoogle Scholar
  30. 30.
    Migueles JH, Cadenas-Sanchez C, Ekelund U, Nyström CD, Mora-Gonzalez J, Löf M, Labayen I, Ruiz JR, Ortega FB (2017) Accelerometer data collection and processing criteria to assess physical activity and other outcomes: a systematic review and practical considerations. Sports Med.  https://doi.org/10.1007/s40279-017-0716-0 Google Scholar
  31. 31.
    Petterson SC, Mizner RL, Stevens JE, Raisis L, Bodenstab A, Newcomb W, Snyder-Mackler L (2009) Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum 61:174–183CrossRefGoogle Scholar
  32. 32.
    Physical Activity Guidelines Advisory Committee Report (2018) Recap: 2018 Physical Activity Guidelines Advisory Committee Meeting 3| Health.gov. News Media HealGoogle Scholar
  33. 33.
    Schache MB, McClelland JA, Webster KE (2014) Lower limb strength following total knee arthroplasty: a systematic review. Knee 21:12–20CrossRefGoogle Scholar
  34. 34.
    Straker L, Campbell A, Mathiassen SE, Abbott RA, Parry S, Davey P (2014) Capturing the pattern of physical activity and sedentary behavior: exposure variation analysis of accelerometer data. J Phys Act Health 11:614–625CrossRefGoogle Scholar
  35. 35.
    Sun F, Norman IJ, While AE (2013) Physical activity in older people: a systematic review. BMC Public Health 13:449CrossRefGoogle Scholar
  36. 36.
    Tsonga T, Kapetanakis S, Papadopoulos C, Papathanasiou J, Mourgias N, Georgiou N, Fiska A, Kazakos K (2011) Evaluation of improvement in quality of life and physical activity after total knee arthroplasty in Greek elderly women. Open Orthop J 5:343–347CrossRefGoogle Scholar
  37. 37.
    Tudor-Locke C, Schuna JM, Barreira TV, Mire EF, Broyles ST, Katzmarzyk PT, Johnson WD (2013) Normative steps/day values for older adults: NHANES 2005–2006. J Gerontol A Biol Sci Med Sci 68:1426–1432CrossRefGoogle Scholar
  38. 38.
    Vissers MM, Bussmann JB, de Groot IB, Verhaar JAN, Reijman M (2013) Physical functioning 4 years after total hip and knee arthroplasty. Gait Posture 38:310–315CrossRefGoogle Scholar
  39. 39.
    Walker DJ, Heslop PS, Chandler C, Pinder IM (2002) Measured ambulation and self-reported health status following total joint replacement for the osteoarthritic knee. Rheumatol Oxf Engl 41:755–758CrossRefGoogle Scholar
  40. 40.
    Wallis JA, Webster KE, Levinger P, Taylor NF (2013) What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis. Osteoarthr Cartil 21:1648–1659CrossRefGoogle Scholar
  41. 41.
    Webber SC, Strachan SM, Pachu NS (2017) Sedentary behavior, cadence, and physical activity outcomes after knee arthroplasty. Med Sci Sports Exerc 49:1057–1065CrossRefGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Emmanuel Frimpong
    • 1
  • Joanne A. McVeigh
    • 1
    • 2
  • Dick van der Jagt
    • 3
  • Lipalo Mokete
    • 3
  • Yusuf S. Kaoje
    • 1
  • Mohammed Tikly
    • 4
  • Rebecca M. Meiring
    • 1
    Email author
  1. 1.Movement Physiology Research Laboratory, School of Physiology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
  2. 2.School of Occupational Therapy and Social WorkCurtin UniversityPerthAustralia
  3. 3.Division of Orthopaedics, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
  4. 4.Division of Rheumatology, Department of Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa

Personalised recommendations