Impact of variation in physical activity after total joint replacement

Abstract

PurposePatients who undergo total knee arthroplasty (TKA) or total hip arthroplasty (THA) often develop postoperative pain. Exercise approaches are recommended postoperatively; however, the impact of excessive variation in physical activity is unclear. The purpose of the present preliminary study was to investigate the impact of excessive variation in physical activity using the accelerometer in the early period after TKA or THA.Patients and methodsSeventy-two patients were enrolled in the study. Forty patients underwent initial TKA, and 32 initial THA. Physical activity was measured for 8 days from postoperative day 3 to 10. Patients with substantial correlation between physical activity and postoperative day were classified as the “good-pacing” group. Patients with no correlation between them were classified as the “poor-pacing” group. They were also evaluated using a pain visual analog scale (VAS), pain catastrophizing scale, and hospital anxiety and depression scale.ResultsThe average age was 68 years, and 59 patients (82%) were women. The average maximum number of steps per day was 2,181. There were 45 patients with good pacing and 27 with poor pacing. The poor-pacing group showed significantly lower maximum number of steps per day, higher postoperative average VAS score, higher postoperative worst VAS score, and longer duration of postoperative hospital stay than the good-pacing group.ConclusionPatients with excessive variation in physical activity showed severe postoperative pain and prolonged postoperative hospital stay. The postoperative variation in physical activity could be an outcome for improvement in patients after lower-limb arthroplasty.

Current clinical utilisation of wearable motion sensors for the assessment of outcome following knee arthroplasty: a scoping review

“…Physical activity studies were consistent in the number of sensors implemented, with 21 studies (81%) using a single sensor for activity measurements 35–40 42 43 45–57. As technology and availability of wearable accelerometers has progressed, the type of sensor used has also changed.…”

“…In studies published between 2008 and 2016, nine studies (69%)36 37 40 42 44 45 58–60 reported using a uniaxial accelerometer versus just three studies (23%)46 55 56 using a triaxial accelerometer. Conversely, in studies published in 2017–2019, eight studies (62%)35 38 47 49 50 53 54 57 reported using a triaxial accelerometer, while only three (23%)39 43 45 used a uniaxial accelerometer. Overall, three studies did not report the number of axes recorded,41 48 51 and most studies within this subgroup (73%)36 37 40–45 47 48 50–55 57 60 did not report the sampling rate at which data were collected.…”

“…Conversely, in studies published in 2017–2019, eight studies (62%)35 38 47 49 50 53 54 57 reported using a triaxial accelerometer, while only three (23%)39 43 45 used a uniaxial accelerometer. Overall, three studies did not report the number of axes recorded,41 48 51 and most studies within this subgroup (73%)36 37 40–45 47 48 50–55 57 60 did not report the sampling rate at which data were collected. No standard frequency was observed within studies reporting sampling rate, as two studies collected data at 10 Hz,39 56 two at or near 30 Hz49 58 and three at 100 Hz 35 38 46.…”

“…Three studies compared physical activity levels of knee replacement patients with a total of 272 healthy controls 35 39 40. Four studies also included physical activity from measures from total hip replacement patients for comparison with knee patients 41–44…”

“…No standard frequency was observed within studies reporting sampling rate, as two studies collected data at 10 Hz,39 56 two at or near 30 Hz49 58 and three at 100 Hz 35 38 46. Accelerometers were mounted at hip or waist level, most commonly with an elastic strap, in half of the included physical activity studies 36–38 42 43 45–47 49 50 53 56 58. Seven studies positioned sensors on the thigh,35 39 41 44 48 58 60 four on the sternum,41 44 59 60 four on the lower leg,40 52 54 59 one on the foot59 and two on the wrist 51 57…”