Being active with a total hip or knee prosthesis: a systematic review into physical activity and sports recommendations and interventions to improve physical activity behavior (original) (raw)
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International Journal of Environmental Research and Public Health, 2021
Total hip replacement (THR) and total knee replacement (TKR) are among the most common elective surgical procedures. There is a large consensus on the importance of physical activity promotion for an active lifestyle in persons who underwent THR or TKR to prevent or mitigate disability and improve the quality of life (QoL) in the long term. However, there is no best practice in exercise and physical activity specifically designed for these persons. The present protocol aims to evaluate the efficacy and safety of an exercise program (6 month duration) designed for improving quality of life in people who had undergone THR or TKR. This paper describes a randomized controlled trial protocol that involves persons with THR or TKR. The participant will be randomly assigned to an intervention group or a control group. The intervention group will perform post-rehabilitation supervised training; the control group will be requested to follow the usual care. The primary outcome is QoL, measured...
Habitual Physical Activity After Total Knee Replacement
Physical Therapy, 2012
Background Previous studies on physical activity after total knee arthroplasty (TKA) concentrated mainly on a return to sports activities. Objective The objectives of this study were to determine the habitual physical activity behavior of people who had undergone TKA (TKA group) 1 to 5 years after surgery and to examine to what extent they adhered to international guidelines for health-enhancing physical activity. Additional aims were to compare younger (<65 years old) and older (≥65 years old) people as well as men and women in the TKA group and to compare the results for the TKA group with those for a sex- and age-matched normative population (normative group). Design This investigation was a cohort study. Methods All people who had a primary TKA at 1 of 2 participating hospitals between 2002 and 2006 were sent the Short Questionnaire to Assess Health-Enhancing Physical Activity at least 1 year after surgery. Results The TKA group spent, on average, 1,347 minutes per week on ph...
Journal of Physiotherapy, 2012
Questions: What proportion of people after total knee arthroplasty adheres to the physical activity regimen recommended for What factors are associated with adherence to these recommendations? Design: An observational study. Participants: 830 adults who underwent a total knee arthroplasty between 2002 and 2006 at University Medical Center Gronigen or Martini Hospital Gronigen, the Netherlands. Outcome measures: The Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) was used to measure the physical activity behaviour of the participants. These data were analysed as adherence to each recommendation. Results: The health recommendation was adhered to by 51% of the participants. The fitness recommendation was adhered to by 53% of participants. Almost half (46%) of the participants fulfilled both recommendations, and 42% did not fulfil either recommendation. Males and more educated participants had higher odds of meeting the health, fitness, and both recommendations. Respondents living with family had higher odds of meeting the fitness recommendation. Conclusion: After total knee arthroplasty, 42% of people are not active enough to maintain their health and fitness. Physiotherapists should encourage people with a total knee arthroplasty to undertake the recommended exercise regimens to maintain health and fitness, with particular attention to those people with characteristics known to be associated with poor adherence to the recommendations. [Groen J, Stevens M, Kersten RFMR, Reininga IHF, van den Akker-Scheek I (2012) After total knee arthroplasty, many people are not active enough to maintain their health and fitness: an observational study. Journal of Physiotherapy 58: 113-116]
BMC musculoskeletal disorders, 2015
Although the outcome of total knee replacement (TKR) is favorable, surgery alone fails to resolve the functional limitations and physical inactivity that existed prior to surgery. Exercise is likely the only intervention capable of improving these persistent limitations, but exercises have to be performed with intensity sufficient to promote significant changes, at levels that cannot be tolerated until later stages post TKR. The current evidence is limited regarding the effectiveness of exercise at a later stage post TKR. To that end, this study aims to compare the outcomes of physical function and physical activity between 3 treatment groups: clinic-based individual outpatient rehabilitative exercise during 12 weeks, community-based group exercise classes during 12 weeks, and usual medical care (wait-listed control group). The secondary aim is to identify baseline predictors of functional recovery for the exercise groups. This protocol paper describes a comparative effectiveness st...
Arthritis care & research, 2018
This study aimed to describe the: rates of participation in regular physical activity (PA) pre- and 3-years following knee or hip arthroplasty; factors associated with participation post-surgery; and types of activity undertaken. A previously acquired, multicentre, prospective cohort of knee or hip arthroplasty recipients was followed-up 3-years post-surgery. Regular participation in PA was defined as participation in PA ≥1 times/week, excluding incidental activities. Participants were interviewed about current participation as well as participation in the year pre-surgery. Joint-specific and health-related quality of life scores and experience of major complications were obtained. Co-morbid information and body weight were updated. Factors associated with 3-year PA participation were determined using multivariable logistic regression modelling. 74% (1289/1773) of the eligible cohort were followed-up (718 knee, 571 hip). Participation profiles were similar regardless of joint replac...
Athletic participation after hip and knee arthroplasty
Bulletin of the Nyu Hospital For Joint Diseases, 2010
The issue of athletic participation after hip and knee arthroplasty has become more relevant in recent years, with an increase in the number of young and active patients receiving joint replacements. This article reviews patient-, surgery-, implant-, and sports-related factors, and discusses currently available guidelines that should be considered by the physician when counseling patients regarding a return to athletic activity after total joint arthroplasty. Current evidence regarding appropriate athletic participation after total hip arthroplasty, resurfacing hip arthroplasty, total knee arthroplasty, and unicondylar knee arthroplasty is reviewed.
Arthritis care & research, 2017
To test the feasibility of a comprehensive behavioral intervention (CBI) program that combines intense exercises with an education program to be implemented at a later stage (3 months) post total knee replacement (TKR), and to get a first impression of the effects of the CBI as compared to a standard of care exercise (SCE) program on the outcomes of physical function and physical activity. 44 subjects participated in a 3-month program of either CBI or SCE followed by 3 months of home exercise program. Outcomes of physical function and physical activity were measured at baseline and at 6-month follow-up. ANOVA was used to compare statistical differences between groups whereas responder analyses was used for clinically important differences. The CBI was found to be safe and well tolerated. As compared to the SCE group, the CBI group had less pain (p= .035) and better physical function based on the RAND questionnaire (p=.017) and the single-leg stance test (p=.037). The other outcome m...
Arthritis Care & Research, 2010
Objective. Despite its impact on the overall outcome and health-related quality of life (HRQOL) after knee surgery, physical activity has not been investigated directly using accelerometry or step monitoring during the first year after total knee arthroplasty (TKA) due to osteoarthritis (OA). Therefore, the present study aimed to evaluate the development of physical activity over 12 months after surgery and its relationship to clinical outcome and HRQOL. Methods. Fifty-three patients scheduled for primary TKA due to OA were measured with the DynaPort ADL monitor and a step activity monitor preoperatively and at 2, 6, and 12 months of followup. Clinical outcome and HRQOL were investigated using the American Knee Society Score (KSS) and Short Form 36 (SF-36) health survey. Results. Physical activity increased significantly within 12 months of followup (from mean ؎ SD 4,993 ؎ 2,170 gait cycles preoperatively to 5,932 ؎ 2,111 gait cycles; P ؍ 0.003). Clinical outcome and HRQOL improved from baseline (mean ؎ SD KSS 88.9 ؎ 21.4, mean ؎ SD SF-36 43.1 ؎ 18.4) to 12 months of followup (mean ؎ SD KSS 188.6 ؎ 10.9; P ؍ 0.001 and mean ؎ SD SF-36 82.5 ؎ 15.9; P ؍ 0.001). Physical activity parameters did not correlate with clinical outcome. Conclusion. TKA offers profound improvements of physical activity for the majority of patients. Despite these improvements and the excellent clinical outcome, most patients do not reach the level of physical activity reported for healthy subjects. The activity level after treatment seems to be influenced by physical activity behavior prior to surgery rather than by the treatment itself.
Physical therapy, 2018
The definitive treatment for knee osteoarthritis is a total knee replacement, which results in a clinically meaningful improvement in pain and physical function. However, evidence suggests that physical activity (PA) remains unchanged after total knee replacement (TKR). The objective of this study is to investigate the efficacy, fidelity, and safety of a physical therapist-administered PA intervention for people after TKR. This study will be a randomized controlled trial. The setting is an outpatient physical therapy clinic. The participants are 125 individuals who are over the age of 45 and are seeking outpatient physical therapy following a unilateral TKR. In addition to standardized physical therapy after TKR, the intervention group will receive, during physical therapy, a weekly PA intervention that includes a wearable activity tracking device, individualized step goals, and face-to-face feedback provided by a physical therapist. The control group will receive standardized physi...