Is there a difference in physical activity levels in patients before and up to one year after unilateral total hip replacement? A systematic review and meta-analysis

Abstract

Objective:To determine the difference in physical activity levels before and up to one year after unilateral primary total hip replacement.Data sources:A search was performed on 13 July 2016. Studies were eligible for inclusion if they presented preoperative and up to one year postoperative measures of physical activity for patients who had undergone unilateral primary total hip replacement.Review methods:Any article that used a measure of physical activity pre and up to one year post-unilateral primary total hip replacement. Data was synthesised using a meta-analysis with 95% confidence intervals (CI), if appropriate. The Critical Appraisal Skills Programme cohort study checklist was used to assess the quality of evidence.Results:From 6024 citations, 17 studies were selected: Nine studies were analysed in a meta-analysis and eight studies were analysed qualitatively. The quality of the evidence was ‘low’ to ‘moderate’. There was no statistically significant difference in physical activity pre- to post-total hip replacement when assessed using: movement-related activity (mean difference (MD): −0.08; 95% CI: 1.60, 1.44; I2 = 0%; n = 77), percentage of 24-hours spent walking (MD: −0.21; 95% CI: −1.36, 0.93; I2 = 12%; n = 65), 6-minute walk test (MD: −60.85; 95% CI: −122.41, 0.72; I2 = 84%; n = 113) or the cardiopulmonary exercise test (MD: −0.24; 95% CI: −1.36, 0.87; I2 = 0%; n = 76).Conclusion:There is no statistically significant difference in physical activity levels before and up to one year after unilateral primary total hip replacement. However, the low to moderate methodological quality of the included articles should be taken into consideration when drawing conclusions.

The Influence of Preoperative Physical Activity on Postoperative Outcomes of Knee and Hip Arthroplasty Surgery in the Elderly: A Systematic Review

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Strengthening Quadriceps Muscles with Neuromuscular Electrical Stimulation Following Total Hip Replacement: a Review

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Inertial Sensor-Based Gait and Attractor Analysis as Clinical Measurement Tool: Functionality and Sensitivity in Healthy Subjects and Patients With Symptomatic Lumbar Spinal Stenosis

“…The attractor index in our patients was below the fatigue index cut-off for motor fatigue (δ F = 4) reported by Sehle et al ( 2014 ). Because we limited the walking exercise to 6 min based on the widely accepted use of the 6MWT in clinical cohorts (Gao et al, 2014 ; Dunn et al, 2015 ; O'Brien et al, 2016 ; Keilani et al, 2017 ; Withers et al, 2017 ), it is remarkable that we still observed greater changes in attractor variability in patients than in healthy persons. It is unknown if patients in our study would have experienced even greater changes in attractor variability if they would have continued to walk until exhaustion or inability to continue due to sLSS symptoms.…”