1 Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia.
2 South Western Sydney Local Health District, Warwick Farm, NSW, Australia.
Clin Rehabil. 2018 Sep;32(9):1271-1283. doi: 10.1177/0269215518769986. Epub 2018 Apr 25.
This study aims to evaluate the prevalence and determinants of inadequate physical activity and excessive sedentary behaviour before and after total knee replacement.
DESIGN, SETTING AND SUBJECTS: Secondary analysis was performed on data from a cohort of 422 adults (45-74 years), drawn from 12 public or private hospitals, undergoing primary unilateral or bilateral total knee replacement surgery.
Questionnaires were used to determine the presence of inadequate physical activity and excessive sedentary behaviour before and 6 and 12 months after total knee replacement surgery. Knee pain, activity limitations, comorbidities, muscle strength, psychological well-being, fatigue, sleep and body mass index were measured/assessed as possible determinants of physical activity or sedentary behaviour.
Before surgery, 77% ( n = 326) of the cohort participated in inadequate physical activity according to World Health Organization guidelines, and 60% ( n = 253) engaged in excessive sedentary behaviour. Twelve months after surgery, 53% ( n = 185) of the cohort engaged in inadequate physical activity and 45% ( n = 157) in excessive sedentary behaviour. Inadequate physical activity before surgery ( P = 0.02), obesity ( P = 0.07) and comorbidity score >6 ( P = 0.04) predicted inadequate physical activity 12 months after surgery. Excessive sedentary behaviour and activity limitations before surgery predicted excessive sedentary behaviour 12 months after surgery.
Although there were improvements after total knee replacement, 12 months after surgery about half the cohort did not meet World Health Organization recommendations for activity. Pre-surgery assessment of physical activity, activity limitations, sedentary behaviour and body mass index is essential to identify patients at risk for long-term inactivity.
本研究旨在评估全膝关节置换前后身体活动不足和久坐行为过多的患病率及其决定因素。
设计、地点和研究对象：对来自 12 家公立医院和私立医院的 422 名（45-74 岁）接受单侧或双侧初次全膝关节置换术的成年人队列数据进行二次分析。
使用问卷确定全膝关节置换术前和术后 6 个月和 12 个月时身体活动不足和久坐行为过多的情况。膝关节疼痛、活动受限、合并症、肌肉力量、心理幸福感、疲劳、睡眠和体重指数作为身体活动或久坐行为的可能决定因素进行测量/评估。
术前，根据世界卫生组织的指南，队列中有 77%（n=326）的人进行了身体活动不足，60%（n=253）的人久坐行为过多。术后 12 个月，队列中有 53%（n=185）的人进行了身体活动不足，45%（n=157）的人久坐行为过多。术前身体活动不足（P=0.02）、肥胖（P=0.07）和合并症评分>6（P=0.04）预测术后 12 个月身体活动不足。术前久坐行为和活动受限预测术后 12 个月久坐行为过多。
尽管全膝关节置换术后有所改善，但术后 12 个月时，约一半的队列不符合世界卫生组织的活动建议。术前对身体活动、活动受限、久坐行为和体重指数进行评估对于识别长期不活动的高危患者至关重要。
