Validity of Tools to Measure Physical Activity in Older Adults Following Total Knee Arthroplasty

2020 ◽  
pp. 1-8
Author(s):  
Lisa Jasper ◽  
Lauren A. Beaupre ◽  
John C. Spence ◽  
C. Allyson Jones
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Total Knee Arthroplasty ◽  
Energy Expenditure ◽  
Knee Arthroplasty ◽  
Intraclass Correlation ◽  
Self Report ◽  
Measurement Tool ◽  
Energy Expenditures ◽  
Total Knee

Few validated tools exist for measuring physical activity following total knee arthroplasty (TKA) despite the importance of returning to sufficient levels of physical activity post-TKA to achieve health benefits. This study examined the validity of two clinical measures—the Fitbit, a commercially available personal activity monitor, and the Community Healthy Activities Model Program for Seniors (CHAMPS), a self-report questionnaire—compared with a reference standard accelerometer, the SenseWearTM Armband (SWA). At 6-month post-TKA, 47 participants wore the Fitbit and SWA for 4 days and then completed the CHAMPS. Moderate-to-good correlation was observed between the Fitbit and SWA for steps (intraclass correlation coefficient [ICC] = .79), energy expenditure (ICC = .78), and energy expenditure <3 METS (ICC = .79). Poor-to-moderate correlation was observed between the CHAMPS and SWA (ICC = .43) with the questionnaire reporting lower daily energy expenditures than the SWA. Results showed that Fitbit may be a reasonable measurement tool to measure steps and energy expenditures in older adults following TKA.

scholarly journals MAFbx, MuRF1, and the stress-activated protein kinases are upregulated in muscle cells during total knee arthroplasty

2012 ◽  
Vol 303 (4) ◽  
pp. R376-R386 ◽  
Author(s):  
Ashley N. Bailey ◽  
Austin D. Hocker ◽  
Benjamin R. Vermillion ◽  
Keith Smolkowski ◽  
Steven N. Shah ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Muscle Protein ◽  
Vastus Lateralis ◽  
Cost Effective ◽  
Mrna Levels ◽  
Tourniquet Time ◽  
Total Knee ◽  
Expanding Population

Total knee arthroplasty (TKA) is the most common and a cost-effective surgical remediation for older adults with long-standing osteoarthritis. In parallel with the expanding population of older adults, the number of TKAs performed annually is projected to be 3.48 million by 2030. During this surgery, a tourniquet is used to stop blood flow to the operative leg. However, the molecular pathways that are affected by tourniquet use during TKA continue to be elucidated. We hypothesized that components of the catabolic FoxO3a (i.e., MuRF1, MAFbx, and Bnip3) pathway, as well as the cellular stress pathways [i.e., stress-activated protein kinase (SAPK)/JNK and MAPKs], are upregulated during TKA. The purpose of this study was to measure changes in transcripts and proteins involved in muscle cell catabolic and stress-activated pathways. We obtained muscle biopsies from subjects, 70 ± 1.3 yr, during TKA, from the vastus lateralis at baseline (before tourniquet inflation), during maximal ischemia (just before tourniquet release), and during reperfusion. Total tourniquet time was 43 ± 2 min and reperfusion time was 16 ± 1. Significant increases in FoxO3a downstream targets, MAFbx and MuRF1, were present for mRNA levels during ischemia (MAFbx, P = 0.04; MuRF1, P = 0.04), and protein expression during ischemia (MAFbx, P = 0.002; MuRF1, P = 0.001) and reperfusion (MuRF1, P = 0.002). Additionally, stress-activated JNK gene expression ( P = 0.01) and protein were elevated during ischemia ( P = 0.001). The results of this study support our hypothesis that protein degradation pathways are stimulated during TKA. Muscle protein catabolism is likely to play a role in the rapid loss of muscle volume measured within 2 wk of this surgery.

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

2017 ◽  
Vol 4 (3) ◽  
pp. 1-8 ◽  
Author(s):  
Gustavo J Almeida ◽  
Lauren Terhorst ◽  
James J ◽  
Irrgan g ◽  
G. Kelley Fitzgerald ◽  
...  
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Exercise Programs ◽  
Activity Measures ◽  
Total Knee

Does Preoperative Pain Catastrophizing Influence Objectively Measured Physical Activity Before and After Total Knee Arthroplasty: A Prospective Cohort Study

2020 ◽  
pp. 1-7
Author(s):  
Sara Birch ◽  
Torben Bæk Hansen ◽  
Maiken Stilling ◽  
Inger Mechlenburg
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Muscle Mass ◽  
Knee Arthroplasty ◽  
Pain Catastrophizing ◽  
Knee Function ◽  
Preoperative Pain ◽  
Before And After ◽  
Total Knee

Background: Pain catastrophizing is associated with pain both before and after a total knee arthroplasty (TKA). However, it remains uncertain whether pain catastrophizing affects physical activity (PA). The aim was to examine the influence of pain catastrophizing on the PA profile, knee function, and muscle mass before and after a TKA. Methods: The authors included 58 patients with knee osteoarthritis scheduled for TKA. Twenty-nine patients had a score >22 on the Pain Catastrophizing Scale (PCS), and 29 patients had a score <11. PA was measured with a triaxial accelerometer preoperative, 3 months, and 12 months after TKA. Other outcome measures consisted of the Knee Osteoarthritis Outcome Score and dual-energy X-ray absorptiometry scans. Results: The authors found no difference in PA between patients with a better/low or a worse/high score on the PCS, and none of the groups increased their mean number of steps/day from preoperative to 12 months postoperative. Patients with better/low PCS scores had higher/better preoperative scores on the Knee Osteoarthritis Outcome Score subscales (symptoms, pain, and activity of daily living), and they walked longer in the 6-min walk test. Further, they had lower body mass index, lower percent fat mass, and higher percent muscle mass than patients with worse/high PCS scores both before and after a TKA. Conclusion: Preoperative pain catastrophizing did not influence PA before or after a TKA. Although the patients improved substantially in self-reported knee function, their PA did not increase. This may be important to consider when the clinicians are informing the patients about the expected benefits from the operation.

Treatment of Pain in Total Knee Arthroplasty Favoring Post-op Physical Activity

2015 ◽  
pp. 2533-2539
Author(s):  
Francesco Benazzo ◽  
Matteo Ghiara ◽  
Stefano Marco Paolo Rossi
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Total Knee

scholarly journals Accelerometer Measured Sedentary and Physical Activity Behaviors of Working Patients after Total Knee Arthroplasty, and their Compensation Between Occupational and Leisure Time

2020 ◽  
Author(s):  
T. H. Hylkema ◽  
S. Brouwer ◽  
C. M. Kooijman ◽  
A. J. De Vries ◽  
F. Breukelman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Light Intensity ◽  
Knee Arthroplasty ◽  
Leisure Time ◽  
Multilevel Models ◽  
Working Age ◽  
Total Knee ◽  
One Year ◽  
Sedentary Bouts

Abstract Purpose Objective measurements of sedentary and physical activity (PA) behavior are scarce among working-age patients who undergo total knee arthroplasty (TKA). Aim was to assess sedentary and PA behaviors using accelerometers and to identify compensation effects between occupational and leisure time of sedentary and PA behavior. Methods One year post-TKA, 51 patients wore an ActiGraph(GT3x) accelerometer for 7 days. Sedentary time, prolonged sedentary bouts (≥ 30 min) and PA (light-intensity and moderate-to-vigorous PA) were examined. Compliance with the guideline of > 150 min moderate-to-vigorous PA per week was calculated. Compensation effects were analyzed using multilevel models, splitting effects into routine and within-day compensation, stratifying by physical and non-physical jobs. The routine compensation effects are the ones of interest, representing habitual compensation during a week. Results Participants spent 60% of time in sedentary bouts and 17% in prolonged sedentary bouts, with 37% of PA spent in light-intensity and 3% in moderate-to-vigorous activity. About 70% of patients met the PA guideline. Routine compensation effects were found for workers in physical jobs, who compensated for their occupational light-intensity PA with less light-intensity PA during leisure time. Workers in non-physical jobs did not compensate for their occupational prolonged sedentary bouts, as these continued during leisure time. Conclusion This study showed that working TKA patients are highly sedentary 1 year after surgery, but most met the PA guideline. Especially those with non-physical jobs do not compensate for their occupational prolonged sedentary bouts. This stresses the need to stimulate PA among TKA patients not complying with the guidelines and those with non-physical jobs.

A Pilot Study Evaluating Presurgery Neuroanatomical Biomarkers for Postoperative Cognitive Decline After Total Knee Arthroplasty in Older Adults

2014 ◽  
Vol 58 (4) ◽  
pp. 173-174
Author(s):  
Catherine C. Price ◽  
Jared J. Tanner ◽  
Ilona Schmalfuss ◽  
Cynthia Wilson Garvan ◽  
Peter Gearen ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Knee Arthroplasty ◽  
Pilot Study ◽  
Cognitive Decline ◽  
Knee Arthroplasty ◽  
Postoperative Cognitive Decline ◽  
Total Knee

Role of telerehabilitation in patients following total knee arthroplasty: Evidence from a systematic literature review and meta-analysis

2016 ◽  
Vol 23 (2) ◽  
pp. 339-346 ◽  
Author(s):  
H Shukla ◽  
SR Nair ◽  
D Thakker
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Control Group ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Total Knee

Introduction Increased physical activity and functional ability are the goals of total knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery of patients after discharge from hospital following total knee arthroplasty (TKA). This systematic literature review aimed to evaluate the effectiveness of home telerehabilitation in patients who underwent TKA. Methods Studies published in the English language between 2000 and 2014 were retrieved from Embase, PubMed, and Cochrane databases using relevant search strategies. Two researchers independently reviewed the studies as per the Cochrane methodology for systematic literature review. We considered telerehabilitation sessions as those that were conducted by experienced physiotherapists, using videoconferencing to patients’ homes via an internet connection. The outcomes assessed included: knee movement (knee extension and flexion); quadriceps muscle strength; functional assessment (the timed up-and-go test); and assessment of pain, stiffness, and functional capacity using the Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Results In total, 160 potentially relevant studies were screened. Following the screening of studies as abstracts and full-text publications, six primary publications (four randomized controlled trials, one non-randomized controlled trial, and one single-arm trial) were included in the review. Patients experienced high levels of satisfaction with the use of telerehabilitation alone. There was no significant difference in change in active knee extension and flexion in the home telerehabilitation group as compared to the control group (mean difference (MD) −0.52, 95% CI −1.39 to 0.35, p = 0.24 and MD 1.14, 95% CI −0.61 to 2.89, p = 0.20, respectively). The patients in the home telerehabilitation group showed improvement in physical activity and functional status similar to patients in the conventional therapy group. Discussion The evidence from this systematic literature review demonstrated that telerehabilitation is a practical alternative to conventional face-to-face rehabilitation therapy in patients who underwent TKA.

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