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一项纵向研究的基本原理、设计与方案,该研究旨在评估全膝关节置换术对骨关节炎成年患者习惯性身体活动和久坐行为的影响。

Rationale, design and protocol of a longitudinal study assessing the effect of total knee arthroplasty on habitual physical activity and sedentary behavior in adults with osteoarthritis.

作者信息

Meiring Rebecca M, Frimpong Emmanuel, Mokete Lipalo, Pietrzak Jurek, Van Der Jagt Dick, Tikly Mohammed, McVeigh Joanne A

机构信息

Exercise Physiology Laboratory, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, South Africa.

Division of Orthopaedics, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, South Africa.

出版信息

BMC Musculoskelet Disord. 2016 Jul 13;17:281. doi: 10.1186/s12891-016-1141-5.

Abstract

BACKGROUND

Physical activity levels are decreased and sedentary behaviour levels are increased in patients with knee osteoarthritis (OA). However, previous studies have shown that following total knee arthroplasty (TKA), objectively measured physical activity levels do not change compared to before the surgery. Very few studies have objectively assessed sedentary behaviour following TKA. This study aims to assess patterns of objective habitual physical activity and sedentary behaviour in patients with knee OA and to determine whether these change following TKA.

METHODS

Patients diagnosed with knee osteoarthritis and scheduled for unilateral primary total knee arthroplasty will be recruited from the Orthopaedic Division at the Charlotte Maxeke Johannesburg Academic Hospital. Eligible participants will have assessments completed one week before the scheduled arthroplasty, six weeks, and six months post-operatively. The primary outcomes are habitual physical activity and sedentary behaviour which will be measured using accelerometry (Actigraph GTX3+ and activPal monitors) at the specific time points. The secondary outcomes will be improvements in osteoarthritis-specific quality of life measures using the following questionnaires: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Knee Society Clinical Rating System (KSS), UCLA activity index; subjective pain scores, and self reported sleep quality.

DISCUSSION

The present study will contribute to the field of musculoskeletal health by providing a rich detailed description of the patterns of accumulation of physical activity and sedentary behaviour in patients with knee OA. These data will contribute to existing knowledge using an objective measurement for the assessment of functional ability after total knee arthroplasty. Although studies have used accelerometry to measure physical activity in knee OA patients, the data provided thus far have not delved into the detailed patterns of how and when physical activity is accumulated before and after TKA. Accurate assessment of physical activity is important for physical activity interventions that target special populations.

TRIAL REGISTRATION

NCT02675062 (4 February 2016).

摘要

背景

膝关节骨关节炎(OA)患者的身体活动水平下降,久坐行为水平增加。然而,先前的研究表明,全膝关节置换术(TKA)后,客观测量的身体活动水平与手术前相比没有变化。很少有研究客观评估TKA后的久坐行为。本研究旨在评估膝关节OA患者客观习惯性身体活动和久坐行为模式,并确定TKA后这些模式是否发生变化。

方法

将从夏洛特·马克西克约翰内斯堡学术医院骨科招募被诊断为膝关节骨关节炎并计划进行单侧初次全膝关节置换术的患者。符合条件的参与者将在预定关节置换术前一周、术后六周和六个月完成评估。主要结局是习惯性身体活动和久坐行为,将在特定时间点使用加速度计(Actigraph GTX3+和activPal监测器)进行测量。次要结局将是使用以下问卷改善骨关节炎特异性生活质量指标:西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、膝关节损伤和骨关节炎结局评分(KOOS)、牛津膝关节评分(OKS)、膝关节协会临床评分系统(KSS)、加州大学洛杉矶分校活动指数;主观疼痛评分和自我报告的睡眠质量。

讨论

本研究将通过提供膝关节OA患者身体活动和久坐行为积累模式的丰富详细描述,为肌肉骨骼健康领域做出贡献。这些数据将有助于利用客观测量评估全膝关节置换术后功能能力的现有知识。尽管已有研究使用加速度计测量膝关节OA患者的身体活动,但迄今为止提供的数据尚未深入探讨TKA前后身体活动积累的详细模式。准确评估身体活动对于针对特殊人群的身体活动干预很重要。

试验注册

NCT02675062(2016年2月4日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0a1/4944438/44f64772fd52/12891_2016_1141_Fig1_HTML.jpg

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