Light intensity physical activity increases and sedentary behavior decreases following total knee arthroplasty in patients with osteoarthritis
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To describe objectively measured changes in the volume and pattern of physical activity and sedentary behavior in patients undergoing total knee arthroplasty for osteoarthritis.
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.
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.
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
KeywordsPhysical activity Sedentary behavior Accelerometry Knee osteoarthritis Total knee arthroplasty
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.
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.
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.
An informed consent was obtained from all individuals participants included in the study.
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