Feedback From Activity Trackers Improves Daily Step Count After Knee and Hip Arthroplasty: A Randomized Controlled Trial

Walt, Neill Van der; Salmon, Lucy J.; Gooden, Benjamin; Lyons, Matthew; O’Sullivan, Michael E.; Martina, Kaka; Pinczewski, Leo A.; Roe, Justin

doi:10.1016/j.arth.2018.06.024

Cited by 64 publications

(143 citation statements)

References 21 publications

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“…See flow diagram in Figure 1. which were delivered over 12, 12, 6, 24 and 24 week periods respectively (29)(30)(31)(32)(33) .…”

Section: Study Selectionmentioning

confidence: 99%

“…These targets were reviewed by physical therapists every two weeks and when the targets were not met, the therapists encouraged participants to increase their efforts (29) . The other four RCTs included in this study investigated the use of goal setting strategies with a feedback component among individuals that had undergone joint replacement (30)(31)(32)(33) .…”

Section: Interventionmentioning

confidence: 99%

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Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review

Ishaku

Min

Hall

2020

Curr Phys Med Rehabil Rep

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Background Studies show that following lower-limb joint replacement surgery most patients fail to achieve the recommended amount of physical activity. This study aims to describe and evaluate physical activity interventions in individuals that have undergone hip or knee joint replacement due to osteoarthritis. Design A systematic review. Protocol registration PROSPERO CRD42016033498 (http://www.crd.york.ac.uk/PROSPERO/). Experimental and observational study designs investigating physical activity interventions after joint replacement were considered. The primary outcome was self-reported or objectively measured change in physical activity. Two reviewers extracted the data and appraised the methodological quality of the included studies. Results 11873 studies were screened. Seven studies with 627 participants, aged 50 to 85 years met the review criteria. Five randomised control trial, one longitudinal quasi-experimental study with a control group and one pre/post-test study with control group. Interventions included health coaching, a walking programme, a behavioural change intervention and an alpine skiing intervention delivered between 6 and 24 weeks.Two studies reported change in physical activity using patient activity diaries and five used objective accelerometer data. Statistical pooling of the study results was not possible. However, all studies showed an increase in time spent being physically active in the intervention groups. One study also reported an increase in vitality.Conclusions Few studies have investigated physical activity interventions after hip or knee joint replacement, and evidence for the effectiveness of physical activity interventions post-replacement is low. High quality studies are needed in this area to explore the potential benefits presented within this review.

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“…See flow diagram in Figure 1. which were delivered over 12, 12, 6, 24 and 24 week periods respectively (29)(30)(31)(32)(33) .…”

Section: Study Selectionmentioning

confidence: 99%

Section: Interventionmentioning

confidence: 99%

Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review

Ishaku

Min

Hall

2020

Curr Phys Med Rehabil Rep

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“…A range of 500-3500 steps after THA was recorded during hospitalization (first week approximately) and gender difference was found 41 . The activity level in THA or TKA patients could be increased to 4000-7000 steps per day at 6 weeks after surgery 42 . In the present study, activity level was set as high and low postoperatively in two groups, with a range of set walking distances as the sole variable, with changes analyzed based on X-rays and BMD.…”

Section: Clinical Significancementioning

confidence: 99%

Early Rehabilitation and Periprosthetic Bone Environment after Primary Total Hip Arthroplasty: A Randomized Controlled Trial

Feng

Liu

et al. 2021

Orthopaedic Surgery

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Objective: To investigate whether the periprosthetic bone environment could be affected by activity during the early rehabilitation period after primary total hip arthroplasty (THA) and to evaluate the safety and efficacy of activity during the early rehabilitation period.Methods: This random clinical trial was conducted from January 2017 to July 2017. A total of 22 selected patients with advanced osteonecrosis of the femoral head (ONFH) who underwent primary unilateral THA were randomized (1:1) to a high activity level group (HA group) or a low activity level group (LA group). The HA group included nine men and two women, aged 53.18 AE 13.29 years. The LA group included five men and six women, aged 55.73 AE 11.73 years. The intervention was different postoperative daily walking distances guided by researchers: 1727.27 AE 564.08 m 0-2 months and 4272.73 AE 904.53 m 3-6 months postoperation for the HA group and 909.09 AE 583.87 m 0-2 months and 2409.09 AE 1068.13 m 3-6 months postoperation for LA group. The primary outcomes were radiographic evaluation (prosthetic stability and stress shielding based on the Engh scale) and bone mineral density (BMD) with a femoral prosthesis (individual and intergroup comparison using seven Gruen zones) at 6 months postoperatively. Secondary outcomes were set to confirm the safety and efficacy of activity during early rehabilitation, including day 1 erythrocyte sedimentation rate (ESR), day 1 hypersensitive C-reactive protein (CRP), length of hospital stay (LOS), and the Harris hip score (HHS) at discharge, 2 months postoperatively, and 6 months postoperatively. Results: Patients were followed up for 6 months after surgery. Regarding primary outcomes, all prostheses were assessed as stable, with bone in-growth. There were no adverse events in any cases. The HA group had a higher incidence of stress shielding than the LA group, but there was no statistical significance (63.64% vs 18.18%; P > 0.05). The degree of stress shielding had a different distribution for the two groups (P < 0.05). In the HA group and the LA group, the median percentage difference of the BMD on the operated side was −25% and was −13% in Zone 1, −8% and − 1% in Zone 2, +1% and 3% in Zone 3, +6% and + 6% in Zone 4, −2% and +2% in Zone 5, −3% and −1% in Zone 6, and −24% and −12% in Zone 7 compared with the unoperated side. The BMD was significantly reduced in the medial proximal femur (Zone 1) and the lateral proximal femur (Zone 7) in both groups (P < 0.05). Furthermore, it was increased in the distal femur (Zone 4) in the HA group (P < 0.05). No difference was found in the BMD when comparing between groups. Regarding secondary outcomes, there was no statistical difference in day 1 ESR and day 1 CPR. The average LOS was similar in the HA and LA groups (7.00 days vs 7.18 days, P > 0.05). The HHS on day of discharge was higher in the HA group than in the LA group (60.73 AE 5.37 points vs 51.18 AE 8.05 points, P < 0.05); however, no statistically significant difference was found in postoperative the HHS at 2 month...

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“…In addition, passive tracking of ambulatory activity may be able to identify slower recovery patterns of stroke patients who would benefit from targeted interventions; this use has been previously postulated in patients recovering from orthopedic surgery [11,12]. Further, monitoring ambulatory activity can also be used to encourage greater physical activity and physical fitness, which has previously been demonstrated to be effective in studies of people with diabetes [13], and in patients who have recently undergone knee and hip arthroplasty [14].…”

Section: Introductionmentioning

confidence: 99%

Physical Activity Monitoring Using a Fitbit Device in Ischemic Stroke Patients: Prospective Cohort Feasibility Study

Katzan¹,

Schuster²,

Kinzy³

2021

JMIR Mhealth Uhealth

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Background Continuous tracking of ambulatory activity in real-world settings using step activity monitors has many potential uses. However, feasibility, accuracy, and correlation with performance measures in stroke patients have not been well-established. Objective The primary study objective was to determine adherence with wearing a consumer-grade step activity monitor, the Fitbit Charge HR, in home-going ischemic stroke patients during the first 90 days after hospital discharge. Secondary objectives were to (1) determine accuracy of step counts of the Fitbit Charge HR compared with a manual tally; (2) calculate correlations between the Fitbit step counts and the mobility performance scores at discharge and 30 days after stroke; (3) determine variability and change in weekly step counts over 90 days; and (4) evaluate patient experience with using the Fitbit Charge HR poststroke. Methods A total of 15 participants with recent mild ischemic stroke wore a Fitbit Charge HR for 90 days after discharge and completed 3 mobility performance tests from the National Institutes of Health Toolbox at discharge and Day 30: (1) Standing Balance Test, (2) 2-Minute Walk Endurance Test, and (3) 4-Meter Walk Gait Speed Test. Accuracy of step activity monitors was assessed by calculating differences in steps recorded on the step activity monitor and a manual tally during 2-minute walk tests. Results Participants had a mean age of 54 years and a median modified Rankin scale score of 1. Mean daily adherence with step activity monitor use was 83.6%. Mean daily step count in the first week after discharge was 4376. Daily step counts increased slightly during the first 30 days after discharge (average increase of 52.5 steps/day; 95% CI 32.2-71.8) and remained stable during the 30-90 day period after discharge. Mean step count difference between step activity monitor and manual tally was –4.8 steps (–1.8%). Intraclass correlation coefficients for step counts and 2-minute walk, standing balance, and 4-meter gait speed at discharge were 0.41 (95% CI –0.14 to 0.75), –0.12 (95% CI –0.67 to 0.64), and 0.17 (95% CI –0.46 to 0.66), respectively. Values were similarly poor at 30 days. Conclusions The use of consumer-grade Fitbit Charge HR in patients with recent mild stroke is feasible with reasonable adherence and accuracy. There was poor correlation between step counts and gait speed, balance, and endurance. Further research is needed to evaluate the association between step counts and other outcomes relevant to patients, including patient-reported outcomes and measures of physical function.

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Feedback From Activity Trackers Improves Daily Step Count After Knee and Hip Arthroplasty: A Randomized Controlled Trial

Cited by 64 publications

References 21 publications

Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review

Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review

Early Rehabilitation and Periprosthetic Bone Environment after Primary Total Hip Arthroplasty: A Randomized Controlled Trial

Physical Activity Monitoring Using a Fitbit Device in Ischemic Stroke Patients: Prospective Cohort Feasibility Study

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