1. PHYSICAL ACTIVITY LEVELS DETERMINED BY ACCELEROMETER IN PATIENTS AT
6 MONTHS FOLLOWING TOTAL KNEE ARTHROPLASTY
Alnagmoosh A1 & 2. , Harmer A.1, Simic M1. , Fransen M1.
1 Arthritis and Musculoskeletal Research Group, Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia, 2 Discipline of Physiotherapy, College of Applied Medical Sciences, The University of Dammam, Dammam, Saudi Arabia.
Background
Knee pain in severe osteoarthritis may limit physical activity prior to total knee arthroplasty (TKA). Patients usually report alleviation of pain and improvement of function 6 months after TKA surgery1. However, whether patients have resumed sufficient physical activity 6 months after TKA has not been objectively documented.
Results
Fifty-three participants with TKA (26 women) participated in the study. Forty-seven participants underwent unilateral TKA and 6 participants underwent simultaneous bilateral TKA. Table 1 shows mean age and body mass index.
The participants wore the accelerometers for a mean ± SD of 12.9 ± 1.8 hours per day. Mean steps per day was 6125 ± 3311 steps.
As anticipated, participants spent considerably more time in sedentary activity (568.7 ± min/day) than in moderate and vigorous physical activity (26.7 ± 17.8 min/day).
No differences were found between men and women in wear time (h/day), steps per day (Figure 1) or sedentary time; however, women spent less time (mean difference ± SED, ±4.6 min/day) than men in moderate and vigorous physical activities (*p<0.05; Figure 2).
Only 11% of the cohort (5 men, 1 woman) met the recommendations of the American Heart Association and Australian National Aging Institute to spend at least 30 min per day in moderate activities. 10,000 steps/day was achieved only by two participants (1 man, 1 woman).
Conclusions
This study indicates that the majority of participants (particularly women) who have had a TKA do not meet the international physical activity guidelines 6 months after surgery.
Future studies should focus on examining physical activity levels longitudinally.
Recommendations
Physical therapists are well positioned to encourage and educate patients regarding sufficient physical activity, and this should be an integral component of therapy after TKA.
Table 1 Demographics
Mean (SD)
65 ± 7 years
Age
31.3 ± 5.7 kg/m2
Body Mass Index
Purpose
The aim of this study was to objectively determine the physical activity levels and step count per day using accelerometry among people with TKA and to compare results to international guidelines. Secondly, the study aimed to determine if physical activity was similar between genders after TKA.
Methods
Study participants were tested 6 months after TKA. All participants provided informed consent. Each participant wore the Actigraph GT3XE accelerometer device (ActiGraph, Florida, USA) for 4 days including at least one weekend day. The accelerometer was worn continuously (except bathing and sleeping) and was attached via a comfortable waist band.
Daily activity levels were measured by accelerometry in 10-s epochs. The outcomes included: mean wear time (h)/day, mean steps/day, mean sedentary (sitting/lying) time (min), and mean time (min) spent in moderate and vigorous activity. International guidelines were used to asses adequacy of physical activity for older adults, e.g. 10,000 steps/day2. ActiLife data analysis software v was used to download and analyze the data. Independent-sample T tests were used. Statistical analysis was carried out using SPSS (v 20 ,Chicago, IL). Data are reported as mean ± SD.
References
1- Hamilton DF, Gaston P, Simpson AHRW. Is patient reporting of physical function accurate following total knee replacement? Journal of Bone and Joint Surgery - Series B. 2012;94 B(11):
2-Bohannon, R. W. (2007). Number of pedometer- assessed steps taken per day by adults: a descriptive meta analysis. Phys Ther, 87(12), doi: /ptj
Acknowledgements
Special thanks to our fantastic participants.
Ethical approval was granted by the University of Sydney Research Ethics Committee (2012/842).
Mr Alnagmoosh is a recipient of University of Dammam scholarship (Saudi Arabia).
‘Presented at the WCPT Congress 2015, Singapore’
Contact details
Mr Alnagmoosh’s

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