Department of Physiotherapy, The Alfred, Melbourne, VIC, Australia.
Clin Orthop Relat Res. 2014 May;472(5):1502-11. doi: 10.1007/s11999-013-3427-3. Epub 2013 Dec 19.
People with osteoarthritis (OA) often are physically inactive. Surgical treatment including total hip arthroplasty or total knee arthroplasty can substantially improve pain, physical function, and quality of life. However, their impact on physical activity levels is less clear.
QUESTIONS/PURPOSES: We used accelerometers to measure levels of physical activity pre- and (6 months) postarthroplasty and to examine the proportion of people meeting the American Physical Activity Guidelines.
Sixty-three people with hip or knee OA awaiting arthroplasty were recruited from a major metropolitan hospital. Physical activity was measured using accelerometry before, and 6 months after, surgery. The ActiGraph GT1M (ActiGraph LLC, Fort Walton Beach, FL, USA) was used in this study and is a uniaxial accelerometer contained within a small activity monitor designed to measure human movement through changes in acceleration, which can then be used to estimate physical activity over time. Questionnaires were used to assess patient-reported changes in pain, function, quality of life, and physical activity. Complete data sets (including valid physical activity data) for both time points were obtained for 44 participants (70%). At baseline before arthroplasty, the activity level of patients was, on average, sedentary for 82% of the time over a 24-hour period (based on accelerometry) and self-rated as "sometimes participates in mild activities such as walking, limited shopping, and housework" according to the UCLA activity scale.
There was no change in objectively measured physical activity after arthroplasty. The majority of participants were sedentary, both before and after arthroplasty, and did not meet the American Physical Activity Guidelines recommended to promote health. This was despite significant improvements in self-reported measures of pain, function, quality of life, and physical activity after arthroplasty.
Despite patient-reported improvements in pain, function, and physical activity after arthroplasty, objectively measured improvements in physical activity may not occur. Clinicians should incorporate strategies for improving physical activity into their management of patients after hip and knee arthroplasty to maximize health status. Future research is needed to explore the factors that impact physical activity levels in people after arthroplasty.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
骨关节炎（OA）患者通常身体活动不足。全髋关节置换术或全膝关节置换术等外科治疗可显著改善疼痛、身体功能和生活质量。然而，它们对身体活动水平的影响尚不清楚。
问题/目的：我们使用加速度计来测量术前和（6 个月后）关节置换术后的身体活动水平，并检查符合美国身体活动指南的人数比例。
从一家主要大都市医院招募了 63 名等待关节置换术的髋或膝关节 OA 患者。在手术前和手术后 6 个月使用加速度计测量身体活动。该研究使用 ActiGraph GT1M（ActiGraph LLC，佛罗里达州沃尔顿海滩），这是一种包含在小型活动监测器中的单轴加速度计，旨在通过加速度变化来测量人体运动，然后可以用来估计随时间推移的身体活动。使用问卷评估患者报告的疼痛、功能、生活质量和身体活动的变化。对于两个时间点，均获得了 44 名参与者（70%）的完整数据集（包括有效的身体活动数据）。在关节置换术之前的基线时，患者的活动水平平均在 24 小时内有 82%的时间处于久坐状态（基于加速度计），并且根据 UCLA 活动量表，自我评估为“有时会参加轻度活动，如散步、有限的购物和家务劳动”。
关节置换术后身体活动没有变化。大多数参与者在关节置换术前和术后都久坐不动，并且不符合推荐促进健康的美国身体活动指南。尽管关节置换术后患者自我报告的疼痛、功能、生活质量和身体活动测量值有显著改善。
尽管患者报告的关节置换术后疼痛、功能和身体活动有所改善，但身体活动的客观改善可能不会发生。临床医生应该在髋关节和膝关节置换术后将提高身体活动的策略纳入其患者管理中，以最大限度地提高健康状况。需要进一步研究探讨影响关节置换术后人群身体活动水平的因素。
IV 级，治疗研究。有关完整的证据水平描述，请参阅作者指南。
