Patients’ perceptions of physical activity before and after joint replacement: a systematic review with meta-ethnographic analysis

Abstract

CRD42014014995.

Participation in Regular Physical Activity After Total Knee or Hip Arthroplasty for Osteoarthritis: Prevalence, Associated Factors, and Type

“…Several unmodifiable factors were associated with undertaking physical activity at least once per week (age, education), but some patients simply stated that they believed they were very active doing incidental activity alone. The latter observation is consistent with observations in a recent systematic review of patient perceptions of physical activity after TKA or THA . The authors of that study concluded that people desire to be active postsurgery, not to improve health or address health issues, but for social reasons and enjoyment.…”

“…The authors of that study concluded that people desire to be active postsurgery, not to improve health or address health issues, but for social reasons and enjoyment. Furthermore, increases in obligatory physical activities, such as those of daily living, were highly regarded and potentially deemed more important than more extraordinary physical activity . Taking our observations together with those of Smith et al (43), we believe that future behavior change interventions intended to address the arguably suboptimal participation in activity would ideally focus on altering knowledge and attitudes toward healthy levels of activity.…”

Trajectory of physical activity following total hip and knee arthroplasty: data from the English Longitudinal Study of Ageing (ELSA) cohort

“…It may be that people following THA and TKA have the same physical activity changes and levels but the symptoms during which these activities are undertaken differ. However, as Smith et al [20] acknowledged, people following arthroplasty largely avoid physical activity pursuits if pain is experienced, believing that pain is an indicator for causing harm. Further exploration is warranted to better understand whether clinicians and researchers should consider these two populations separately or collectively when designing physical activity interventions for post-operative rehabilitation.…”

“…Previous literature has attributed such limited change to a number of patient-level and service-level factors. Smith et al [20], in their meta-ethnography on physical activity beliefs and behaviours following THA and TKA, reported that barriers to engagement in higher levels of physical activity compared to pre-arthroplasty were largely related to limited patient information and empowerment, which culminated in fear avoidance on individual's recovery and the longevity of the arthroplasty. This analysis's finding indicates that these international perspectives are mirrored in the English population and therefore there appears an international need to address such issues to facilitate physical activity in this population.…”

“…However the qualitative evidence suggests that this may not be the case [20]. Individuals may have considerable reluctance to increase physical activity following lower limb arthroplasty [20].…”