Responsiveness of Physical Activity Measures Following Exercise Programs after Total Knee Arthroplasty

Almeida, Gustavo J.; Terhorst, Lauren; Irrgang, James J.; Fitzgerald, G. Kelley; Jakicic, John M.; Piva, Sara R.

doi:10.15226/2374-6904/4/3/00164

Cited by 3 publications

(4 citation statements)

References 38 publications

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“…The authors suggested that knowing SB post-operative trajectories in detail would help in tailoring targeted interventions [16]. Although total joint arthroplasty increases functional capacity and relieves OA-related pain, it remains unclear whether and to what extent patients change their objectively measured PA, SB and functional performance post-operation [17,21].…”

Section: Introductionmentioning

confidence: 99%

Objectively Measured Physical Activity, Sedentary Behavior and Functional Performance before and after Lower Limb Joint Arthroplasty: A Systematic Review with Meta-Analysis

Sašek

Kozinc

Löefler

et al. 2021

JCM

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Patients after joint arthroplasty tend to be less physically active; however, studies measuring objective physical activity (PA) and sedentary behavior (SB) in these patients provide conflicting results. The aim of this meta-analysis was to assess objectively measured PA, SB and performance at periods up to and greater than 12 months after lower limb arthroplasty. Two electronic databases (PubMed and Medline) were searched to identify prospective and cross-sectional studies from 1 January 2000 to 31 December 2020. Studies including objectively measured SB, PA or specific performance tests in patients with knee or hip arthroplasty, were included in the analyses both pre- and post-operatively. The risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SIGN). After identification and exclusion, 35 studies were included. The data were analyzed using the inverse variance method with the random effects model and expressed as standardized mean difference and corresponding 95% confidence intervals. In total, we assessed 1943 subjects with a mean age of 64.9 (±5.85). Less than 3 months post-operative, studies showed no differences in PA, SB and performance. At 3 months post-operation, there was a significant increase in the 6 min walk test (6MWT) (SMD 0.65; CI: 0.48, 0.82). After 6 months, changes in moderate to vigorous physical activity (MVPA) (SMD 0.33; CI: 0.20, 0.46) and the number of steps (SMD 0.45; CI: 0.34, 0.54) with a large decrease in the timed-up-and-go test (SMD −0.61; CI: −0.94, −0.28) and increase in the 6MWT (SMD 0.62; CI: 0.26–0.98) were observed. Finally, a large increase in MVPA (SMD 0.70; CI: 0.53–0.87) and a moderate increase in step count (SMD 0.52; CI: 0.36, 0.69) were observed after 12 months. The comparison between patients and healthy individuals pre-operatively showed a very large difference in the number of steps (SMD −1.02; CI: −1.42, −0.62), but not at 12 months (SMD −0.75; −1.89, 0.38). Three to six months after knee or hip arthroplasty, functional performance already exceeded pre-operative levels, yet PA levels from this time period remained the same. Although PA and functional performance seemed to fully restore and exceed the pre-operation levels at six to nine months, SB did not. Moreover, PA remained lower compared to healthy individuals even longer than twelve months post-operation. Novel rehabilitation protocols and studies should focus on the effects of long-term behavioral changes (increasing PA and reducing SB) as soon as functional performance is restored.

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Section: Introductionmentioning

confidence: 99%

Objectively Measured Physical Activity, Sedentary Behavior and Functional Performance before and after Lower Limb Joint Arthroplasty: A Systematic Review with Meta-Analysis

Sašek

Kozinc

Löefler

et al. 2021

JCM

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“…Responsiveness to change in device-based and self-report PA scores between T0 and T1 was assessed using the Standardised Response Mean (SRM) or Cohen's dz (Cohen, 1977;Dankel & Loenneke, 2018;Lakens, 2013;Liang, Fossel, & Larson, 1990), a type of effect size that has been used in previous studies to assess responsiveness to change of device-based and self-report PA instruments in adults and children (e.g. Almeida et al, 2017;Clevenger et al, 2018;Swartz et al, 2014). SRM is calculated for each measure by dividing the absolute mean change score by the standard deviation of differences between the paired measurements and can be interpreted in line with Cohen's d as trivial, small, moderate or large (<0.20, ≥0.20 to <0.50, ≥0.50 to <0.80, and ≥0.80, respectively) (Cohen, 1977;Husted, Cook, Farewell, & Gladman, 2000;Stratford & Riddle, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…according to SRM values (<0.20). Similarly,Almeida et al (2017) examined the responsiveness of selfreport (Community Health Activities Model Program for Older Adults Questionnaire) and two distinct device-based (Actigraph GT3X; Sensewear Armband) measures in detecting changes in PA in older adults with osteoarthritis during a rehabilitation programme following knee replacement surgery. The findings revealed that each PA measure exhibited low responsiveness to change (i.e.…”

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confidence: 99%

Responsiveness of Device-Based and Self-Report Measures of Physical Activity to Detect Behavior Change in Men Taking Part in the Football Fans in Training (FFIT) Program

Donnachie

Hunt

Mutrie

et al. 2020

Journal for the Measurement of Physical Behaviour

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The capacity of physical activity (PA) measures to detect changes in PA within interventions is crucial. This is the first study to examine the responsiveness of activPAL3™ and the International Physical Activity Questionnaire (IPAQ; Short Form) in detecting PA change during a 12-week group-based, men-only weight management program—Football Fans in Training (FFIT). Participants wore an activPAL3™ and completed the IPAQ pre- and post-program (n = 30). Relationships between change scores were assessed by Spearman’s correlations. Mean or median changes in PA were measured using paired samples t-tests and Wilcoxon signed-rank tests. Responsiveness to change was assessed utilizing Standardized Response Mean (SRM). Both device-based and self-report measures demonstrated significant changes pre-post intervention, although these changes were not significantly correlated. The SRM values for changes in activPAL3™ metrics were: 0.54 (for MET-mins/day); 0.53 (for step counts/day); and 0.44 (for MVPA/day), indicating a small to medium responsiveness to change. SRM values for changes in IPAQ scores were: 0.59 (for total PA mins/day); 0.54 (for total MET-mins/day); 0.59 (for walking MET-mins/day); 0.38 (for vigorous MET-mins/day); and 0.38 (for moderate MET-mins/day), revealing a small to medium responsiveness to change. These findings reveal that two commonly used device-based and self-report measures demonstrated responsiveness to changes in PA. While inclusion of both device-based and self-report measures is desirable within interventions it is not always feasible. The results from this study support that self-reported measures can detect PA change within behavioral interventions, although may have a tendency to overestimate changes compared with device-based measures on absolute values, but not standardized response values.

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“…In general, PA is highly variable and can change on a daily basis depending on an individual’s routine and behavior. 37 Therefore, reliable and valid tools are key for consistent and accurate assessment of PA, whereas responsive tools are needed to capture changes over time. Using measurement tools with poor psychometric properties may have contributed to the discrepant findings.…”

Section: Discussionmentioning

confidence: 99%

Physical activity after total joint arthroplasty: a narrative review

Almeida¹,

Khoja²,

Piva³

2018

OAJSM

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BackgroundTotal joint arthroplasty (TJA) is a common procedure to treat individuals with hip and knee osteoarthritis. While TJAs are successful in decreasing pain and improving quality of life, it is unclear whether individuals who undergo TJA become more physically active after surgery. It is possible that TJA, by itself, is not sufficient to affect the behavior of patients toward physical activity (PA) participation. To increase PA participation, individuals with TJA may need to be exposed to exercise/behavioral interventions specifically aimed to promote PA (ie, in addition to the surgery).ObjectivesThis narrative review aimed to assess the evidence on 1) whether TJAs change PA participation from pre- to postsurgery and 2) whether exercise/behavioral interventions delivered before or after TJA help to promote PA in these patients.ResultsFor aim 1, the studies that assessed PA from pre- to post-TJA reported that PA does not change in the first 3 months postsurgery. The results of follow-ups longer than 3 months but shorter than 12 months are contradictory, and the results of follow-ups longer than 12 months provide weak evidence of increased PA. Assessment of changes in PA due to TJA is challenged by the wide variability in demographics, methods used to assess PA, and different pathways of care used across studies. The results for aim 2 were limited by a scarcity of studies that used exercise/behavioral interventions to promote PA.ConclusionTJA relieves joint pain and offers a unique opportunity for patients to become more physically active. However, the current evidence is limited and unable to offer definitive results of whether TJA is effective to change PA from pre- to postsurgery. Future large studies in representative samples of patients with TJA are needed to adequately answer this question.

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Responsiveness of Physical Activity Measures Following Exercise Programs after Total Knee Arthroplasty

Cited by 3 publications

References 38 publications

Objectively Measured Physical Activity, Sedentary Behavior and Functional Performance before and after Lower Limb Joint Arthroplasty: A Systematic Review with Meta-Analysis

Objectively Measured Physical Activity, Sedentary Behavior and Functional Performance before and after Lower Limb Joint Arthroplasty: A Systematic Review with Meta-Analysis

Responsiveness of Device-Based and Self-Report Measures of Physical Activity to Detect Behavior Change in Men Taking Part in the Football Fans in Training (FFIT) Program

Physical activity after total joint arthroplasty: a narrative review

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