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全髋关节或膝关节置换术后体力活动的变化:EPIC-Norfolk 队列的匹配病例对照研究。

Changes in physical activity following total hip or knee arthroplasty: a matched case-control study from the EPIC-Norfolk cohort.

机构信息

1 School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.

2 EPIC, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK.

出版信息

Clin Rehabil. 2017 Nov;31(11):1548-1557. doi: 10.1177/0269215517704270. Epub 2017 Apr 25.

DOI:10.1177/0269215517704270
PMID:28438034
Abstract

OBJECTIVE

To assess self-reported physical activity changes pre- compared to post-operatively in patients undergoing total hip or knee arthroplasty, and to compare this to an age- and gender-matched cohort of people who have not undergone arthroplasty.

DESIGN

Population-based prospective cohort study.

SETTING

Norfolk, United Kingdom.

SUBJECTS

People who had undergone hip or knee arthroplasty, compared to an age- and gender-matched non-arthroplasty cohort.

INTERVENTION

Primary total hip or knee arthroplasty.

MAIN MEASURES

Physical activity, measured using the EPIC Physical Activity Questionnaire (EPAQ2).

RESULTS

A total of 400 people from the EPIC-Norfolk community cohort were identified who had undergone hip or knee arthroplasty. In all, 767 people were identified to form an age- and gender-matched non-arthroplasty cohort. Mean post-operative follow-up was 43 months post-total hip and 41 months post-total knee arthroplasty. There was a statistically significant reduction from pre- to post-arthroplasty in the number of flights of stairs climbed weekly (hip: mean difference (MD): 6.8; P < 0.01; knee: MD: 10.2; P < 0.01), duration of walking (hip: MD: 1.4 hours/week; P = .02; knee: MD: 2.2 hours/week; P < 0.01) and duration of total recreational activity (hip: MD: 1.1 hours/week; P = 0.02). Compared to the non-arthroplasty cohort, duration of physical activity was lower post-total hip arthroplasty (MD: 1.8 hours/week; P = 0.01). The number of flights of stairs climbed weekly (MD: 12.0; P < 0.01), total recreational activity (MD: 1.7 hours/week; P = 0.04) and physical activity energy expenditure (MD: 5.7 Mets-hours/week; P = 0.05) were lower for people post-total knee arthroplasty compared to the matched controls.

CONCLUSIONS

Physical activity did not increase, and in some instances decreased, following total hip or knee arthroplasty.

摘要

目的

评估接受全髋关节或膝关节置换术的患者在术前和术后自我报告的体力活动变化,并将其与未接受关节置换术的年龄和性别匹配的队列进行比较。

设计

基于人群的前瞻性队列研究。

地点

英国诺福克。

研究对象

接受髋关节或膝关节置换术的患者与年龄和性别匹配的非关节置换队列。

干预

初次全髋关节或膝关节置换术。

主要观察指标

使用 EPIC 体力活动问卷(EPAQ2)测量体力活动。

结果

共从 EPIC-Norfolk 社区队列中确定了 400 名接受髋关节或膝关节置换术的患者。总共确定了 767 人形成年龄和性别匹配的非关节置换队列。全髋关节置换术后和全膝关节置换术后的平均随访时间分别为 43 个月和 41 个月。从术前到术后,每周爬楼梯的次数(髋关节:平均差异(MD):6.8;P < 0.01;膝关节:MD:10.2;P < 0.01)、步行时间(髋关节:MD:每周 1.4 小时;P =.02;膝关节:MD:每周 2.2 小时;P < 0.01)和总娱乐活动时间(髋关节:MD:每周 1.1 小时;P = 0.02)均有统计学显著减少。与非关节置换队列相比,全髋关节置换术后体力活动时间较低(MD:1.8 小时/周;P = 0.01)。每周爬楼梯的次数(MD:12.0;P < 0.01)、总娱乐活动时间(MD:每周 1.7 小时;P = 0.04)和体力活动能量消耗(MD:每周 5.7 梅斯小时;P = 0.05)在全膝关节置换术后人群中均低于匹配对照组。

结论

全髋关节或膝关节置换术后体力活动没有增加,在某些情况下甚至减少。

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