Matsunaga-Myoji Yuriko, Fujita Kimie, Ide Shuya, Tabuchi Yasuko, Mawatari Masaaki
Division of Nursing, Faculty of Medicine, Saga University, Saga, Japan.
Department of Health Science, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Orthop Surg (Hong Kong). 2019 Sep-Dec;27(3):2309499019873363. doi: 10.1177/2309499019873363.
There is insufficient evidence regarding the precise levels of physical activity (PA) in older patients following total knee arthroplasty (TKA). The aims of this study were (1) to describe the changes in the amount and intensity of PA before and after TKA with an accelerometer in older patients, compared with age- and sex-matched healthy participants and (2) to assess the effect of TKA on PA depending on age.
Sixty-six primary TKA patients aged 60 years or over (mean age, 73.3 years) wore an accelerometer (Lifecorder EX) for 10 consecutive days and completed the Oxford Knee Score (OKS) before and at 6 months after TKA. PA was evaluated by mean step count and time spent (min) engaged in PA per day. PA intensity was classified as light (1.5-3 metabolic equivalents (METs)), moderate to vigorous (≥3 METs), and total (≥1.5 METs). Sixty-four healthy participants completed a single assessment of PA.
Each of the PA measures and OKS increased significantly after TKA. Compared with healthy controls, light and total PA improved to 100% at 6 months after TKA in patients 75 years or older. By contrast, moderate-to-vigorous PA was 32% of that of the controls and rose to 78% after TKA. PA intensity in patients aged 60-74 years was 31-74% of the controls but did not reach the same level after TKA.
TKA in older patients increases the amount of PA, with light and total PA suitable parameters for assessing PA.
关于全膝关节置换术（TKA）后老年患者的精确体力活动（PA）水平，现有证据不足。本研究的目的是：（1）使用加速度计描述老年患者TKA前后PA量和强度的变化，并与年龄和性别匹配的健康参与者进行比较；（2）根据年龄评估TKA对PA的影响。
66例年龄60岁及以上的初次TKA患者（平均年龄73.3岁）连续10天佩戴加速度计（Lifecorder EX），并在TKA术前和术后6个月完成牛津膝关节评分（OKS）。通过平均步数和每天参与PA的时间（分钟）评估PA。PA强度分为轻度（1.5 - 3代谢当量（METs））、中度至剧烈（≥3 METs）和总体（≥1.5 METs）。64名健康参与者完成了PA的单次评估。
TKA后各项PA指标和OKS均显著提高。与健康对照组相比，75岁及以上患者在TKA术后6个月时，轻度和总体PA提高到了100%。相比之下，中度至剧烈PA为对照组的32%，TKA后升至78%。60 - 74岁患者的PA强度为对照组的31 - 74%，但TKA后未达到相同水平。
老年患者的TKA增加了PA量，轻度和总体PA是评估PA的合适参数。
