Twenty-Four-Hour Movement Behaviors in Adults and Older Adults before Total Knee Arthroplasty: a Study Based on Compositional Data Analysis

Abstract

PURPOSE OF THE STUDYThis study aims to describe and analyze the age differences in the 24-hour movement behavior patterns among a sample of adults and older adults with end-stage knee osteoarthritis referred for total knee arthroplasty (TKA). MATERIAL AND METHODSA total of 86 patients referred for TKA were included in this study. Sleep duration, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) were assessed using multi-day 24-hour raw data from wrist-worn accelerometers. Compositional data analysis was used to analyze the differences between the age categories. RESULTSOn average (SD), the adults were 59.0 (± 4.9) years; 63% female. The older adults were 72.4 (± 5.5) years; 58% female. The adults reached 23.9 milli-gravitational units (mg) as a mean acceleration over the whole day; 34% (8.1 h/day) of the time was classified as sleep, 48.9% (11.7 h/day) as SB, 12.1% (2.9 h/day) as LPA, and 5.1% (72.9 min/day) as MVPA. The older adults reached 21.3 mg; 35.2% (8.4 h/day) of the time was classified as sleep, 50.4% (12.1 h/day) as SB, 11.3% (2.7 h/day) as LPA, and 3.1% (44.9 min/day) as MVPA. Compared with the older adults, the proportion of time spent in total MVPA (P = 0.008) and MVPA bouts of ≥1 min were greater (P ≤ 0.028) in the adult group, while the proportion of time spent in total SB was lower (P = 0.045). No age difference was found for the proportion of time spent asleep. DISCUSSIONSleep, SB, and PA are exclusive and exhaustive parts of the overall 24-h day. Using accelerometer-based measures of 24-hour movement behavior to describe these behaviors more accurately is crucial for a better understanding of patients with end-stage KOA. CONCLUSIONSOur findings suggest that the adults and older adults referred for TKA are physically active despite suffering from severe knee osteoarthritis. Such a high level of physical activity may be difficult to increase by TKA postoperatively. If replicated by other studies, 24-hour movement behaviors should be implemented among the examinations required before TKA.