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Physical activity levels after hip and knee joint replacement surgery: an observational study

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Abstract

Usual care after hip or knee joint replacement does not adequately address the problem of low physical activity levels. We aimed to determine whether exercise delivered in a group setting in the early stage of outpatient rehabilitation influenced self-reported physical activity levels after hip or knee joint replacement. A case series of 79 participants referred to a 6-week outpatient orthopaedic exercise group after total hip or knee replacement were evaluated using the International Physical Activity Questionnaire (IPAQ) short form. Physical function was evaluated using Osteoarthritis Research Society International (OARSI) recommended performance-based tests (30 s Chair Stand Test, 40 m Fast Pace Walk Test, Stair Climb Test, Timed Up and Go Test, 6 Minute Walk Test). Measures were assessed at admission, discharge and 6 weeks after group discharge. Non-parametric analysis was conducted for IPAQ scores. Analysis of functional measures was conducted with linear mixed models with time modelled as a repeated measure. Standard multiple regression and correlation analysis were conducted. Fifty-four participants completed the study. Self-reported activity levels improved significantly at program discharge but not at 6-week follow-up. All performance-based measures improved significantly at program discharge. Fast-paced walking and 6 Minute Walk Test measures continued to improve at 6-week follow-up. Group dynamics present in an outpatient rehabilitation exercise program may increase physical activity levels during group participation but not after group cessation. Performance in all functional measures improved at group discharge.

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Acknowledgments

Lyndon Hawke is the recipient of a scholarship awarded through the National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Total Joint Replacement (APP1116235). Assoc. Professor Michelle Dowsey holds an NHMRC Career Development Fellowship (APP1122526). The authors would like to acknowledge Scott Miller and Janet Robertson from the Angliss Community Rehabilitation Program, Eastern Health, who assisted with this study.

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Authors and Affiliations

  1. School of Allied Health, La Trobe University, Melbourne, Australia

    Lyndon J. Hawke, Nora Shields & Nicholas F. Taylor

  2. Physiotherapy Department, Eastern Health, Box Hill, Australia

    Lyndon J. Hawke

  3. Physiotherapy Department, Angliss Hospital, Talaskia Road, Upper Ferntree Gully, VIC, 3156, Australia

    Lyndon J. Hawke

  4. Department of Orthopaedics and The University of Melbourne Department of Surgery, St. Vincent’s Hospital, Melbourne, Australia

    Michelle M. Dowsey & Peter F. M. Choong

  5. Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia

    Nicholas F. Taylor

Authors
  1. Lyndon J. Hawke
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  2. Nora Shields
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  3. Michelle M. Dowsey
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  4. Peter F. M. Choong
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  5. Nicholas F. Taylor
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Corresponding author

Correspondence to Lyndon J. Hawke.

Ethics declarations

This study was approved by the Eastern Health Human Research Ethics Committee (approval number LR111/1314). Written informed consent was obtained from all participants.

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Key points

• Physical activity levels remain low after hip or knee joint replacement and fail to meet recommended minimal activity guidelines.

• Usual care after hip or knee joint replacement does not appear to address low levels of physical activity.

• Group exercise after hip or knee replacement may increase self-reported physical activity levels during group participation.

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Hawke, L.J., Shields, N., Dowsey, M.M. et al. Physical activity levels after hip and knee joint replacement surgery: an observational study. Clin Rheumatol 38, 665–674 (2019). https://doi.org/10.1007/s10067-018-4317-6

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  • DOI: https://doi.org/10.1007/s10067-018-4317-6

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