Physical activity after total joint arthroplasty: a narrative review

Almeida, Gustavo J.; Khoja, Samannaaz S.; Piva, Sara R.

doi:10.2147/oajsm.s124439

Cited by 28 publications

(28 citation statements)

References 44 publications

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“…Although pain is often identified as a cause for increasing difficulties with mobility and daily living, pain and disability were only moderately correlated. Previous research has shown that pain relief following joint replacement surgery for arthritis is not necessarily associated with increased physical activity (Almeida, Khoja, & Piva, 2018). People with disability due to pain might come to accept their lower level of activity, or may be fearful that activity might bring back the pain that they have previously experienced, and therefore do not necessarily increase activity after pain improves.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of pain predict disabilities affecting daily living in arthritis

James

Walsh

Ferguson

2019

British J Health Psychol

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PurposeTo examine the interplay between pain and disability in arthritis when adjusting for patient heterogeneity in pain progression. There is consistent evidence to suggest that people experience osteoarthritis heterogeneously, with subgroups of people having different trajectories of pain. However, at present it is unclear how these pain trajectories are related to functional disability. We ask the question: Do levels of disability track changes in pain across different pain trajectories?MethodsSecondary analysis of a subset (n = 889) from a cohort of older English adults, representative of the general population (the English Longitudinal Study of Ageing). The relationship between pain and functional disability was compared in three domains of disability: mobility, activities of daily living (ADL) and instrumental ADL. These represent increasingly complex forms of self‐care required for independent living. Data analysis compared the heterogeneous analysis of pain (different trajectories) and disability compared to treating pain as a simpler homogenous construct.ResultsOn a population level, pain was significantly positively correlated with increased disability in all three domains, and the relationship remained stable over time. However, when heterogeneity was examined respondents whose pain improved did not show a corresponding improvement in disability in two domains (ADL and mobility).ConclusionsThese findings highlight how, for some people, alleviating pain, the main symptom of arthritis, might not prevent the persistence or progression of disability. Even when pain improves, further interventions that improve disability are likely to be required. Statement of contribution What is already known on this subject? Pain and functional limitation in daily living are common symptoms of arthritis.Arthritis pain is heterogeneous – there are trajectories of people whose pain gets better or worse.However, to date no study has looked at the relationship between trajectories of arthritis pain and functional disability outside of the minority of people with rheumatoid arthritis. What does this study add? Treating pain as heterogeneous explained disability better than treating pain as a single entity.Respondents in a trajectory of worsening pain reported functional disability in two domains (mobility and activities of daily living) also got worse over time.People in a trajectory of decreasing pain over time did not experience a reduction in disability, despite pain being the most common reason for why people limit their daily functioning.This suggests further intervention is required for people with arthritis, even when the most visible symptoms have been alleviated.

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Section: Discussionmentioning

confidence: 99%

Trajectories of pain predict disabilities affecting daily living in arthritis

James

Walsh

Ferguson

2019

British J Health Psychol

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“…The mean age of the patients was 42 to 67 years, with between 12 and 77 patients. There was no increase in the level of activity after 3 or 12 months [35]. Possible criticisms of this conclusion are that the follow-up was sometimes as low as 3 months, and that some of the studies contained very few patients.…”

Section: How Active Are Patients Really After Hip Replacement?mentioning

confidence: 85%

Hip Arthroplasty with Increased Expectancy

Thiele

Hube²

2019

Z Orthop Unfall

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The patientʼs demands and expectations after total hip arthroplasty have increased significantly. In particular, the athletic function is the focus of the patientʼs interest, whereby not the basic sports ability is inquired, but also the achievable sports level. The benefits of increased activity with a reduction in cardiovascular mortality and the minimization of osteoporosis risk are contrasted by amplified wear followed by prosthesis loosening. Activities are categorized in low-, intermediate- and high-impact kind of sport. Patient-based influencing factors such as physical condition and expertise in his sport, as well as the self-reference of the surgeon to the desired sport influence the recommendation and advice of the patient. Innovations in prosthesis design and materials technology allow meeting patientʼs expectations and aiming to improve the return to sport. After total hip arthroplasty, the majority of preoperatively active patients return to athletic activity, although there is a tendency to shift from “high-impact” to “low-impact” sports. The currently recommended sports include swimming, cycling, Nordic walking, sailing, golf, hiking, dancing and cross-country skiing. A limited recommendation exists for tennis (single), alpine skiing, mountain hiking and sportive running. Not recommended are marathon, football, handball, volleyball, basketball, martial arts, high jump, water skiing and rock climbing. The recommendations are based primarily on expert opinions and are in a progressive extension including “high-impact” sports.

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“…The THA consists of replacing the femoral head and the acetabulum with prosthesis. The surgery purpose is to reduce pain, improve mobility and quality of life the people with hip osteoarthrosis [1]. The type of THA to be performed will depend on the patient needs.…”

Section: Hip Arthroplastymentioning

confidence: 99%

Toward a Design of a Telerehabilitation Program for the Functional Recovery in Post-Hip Arthroplasty Patients

Esparza¹,

Aladro-Gonzalvo²,

Baldeón³

et al. 2019

Assistive and Rehabilitation Engineering

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Telerehabilitation uses new information and communication technologies as an instrument to ensure a distant rehabilitation service. Patients who underwent hip replacement surgery are an excellent case study for the application of this technology. Post-surgical rehabilitation guidelines for hip arthroplasty are well known, and the correct application has a positive effect on the patients' prognosis. However, there are no complementary guidelines for physical therapy that could be used at a distance by patients through a computer platform. This chapter presents a systematic review about conventional physical therapy programs for hip arthroplasty. Based on this review, we proposed therapeutic exercises adapted to a low cost web-platform. In order to reach this objective we will present a brief review of the total hip arthroplasty, telemedicine, telerehabilitation and conventional physical therapy approaches.

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Physical activity after total joint arthroplasty: a narrative review

Cited by 28 publications

References 44 publications

Trajectories of pain predict disabilities affecting daily living in arthritis

Trajectories of pain predict disabilities affecting daily living in arthritis

Hip Arthroplasty with Increased Expectancy

Toward a Design of a Telerehabilitation Program for the Functional Recovery in Post-Hip Arthroplasty Patients

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