Department of Orthopedics, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Occup Rehabil. 2021 Jun;31(2):350-359. doi: 10.1007/s10926-020-09924-9.
Purpose Objective measurements of sedentary and physical activity (PA) behavior are scarce among working-age patients who undergo total knee arthroplasty (TKA). Aim was to assess sedentary and PA behaviors using accelerometers and to identify compensation effects between occupational and leisure time of sedentary and PA behavior. Methods One year post-TKA, 51 patients wore an ActiGraph(GT3x) accelerometer for 7 days. Sedentary time, prolonged sedentary bouts (≥ 30 min) and PA (light-intensity and moderate-to-vigorous PA) were examined. Compliance with the guideline of > 150 min moderate-to-vigorous PA per week was calculated. Compensation effects were analyzed using multilevel models, splitting effects into routine and within-day compensation, stratifying by physical and non-physical jobs. The routine compensation effects are the ones of interest, representing habitual compensation during a week. Results Participants spent 60% of time in sedentary bouts and 17% in prolonged sedentary bouts, with 37% of PA spent in light-intensity and 3% in moderate-to-vigorous activity. About 70% of patients met the PA guideline. Routine compensation effects were found for workers in physical jobs, who compensated for their occupational light-intensity PA with less light-intensity PA during leisure time. Workers in non-physical jobs did not compensate for their occupational prolonged sedentary bouts, as these continued during leisure time. Conclusion This study showed that working TKA patients are highly sedentary 1 year after surgery, but most met the PA guideline. Especially those with non-physical jobs do not compensate for their occupational prolonged sedentary bouts. This stresses the need to stimulate PA among TKA patients not complying with the guidelines and those with non-physical jobs.
目的 在接受全膝关节置换术(TKA)的工作年龄患者中,很少有客观测量的久坐和身体活动(PA)行为。目的是使用加速度计评估久坐和 PA 行为,并确定职业和闲暇时间久坐和 PA 行为之间的补偿效应。
方法 在 TKA 后 1 年,51 名患者佩戴 ActiGraph(GT3x)加速度计 7 天。检查了久坐时间、长时间久坐(≥30 分钟)和 PA(低强度和中到高强度 PA)。计算了每周进行>150 分钟中到高强度 PA 的指南依从性。使用多水平模型分析补偿效应,将效应分为常规补偿和日内补偿,并按体力和非体力工作进行分层。常规补偿效应是我们感兴趣的,代表一周内的习惯性补偿。
结果 参与者有 60%的时间处于久坐状态,17%的时间处于长时间久坐状态,37%的时间处于低强度 PA,3%的时间处于中到高强度活动。大约 70%的患者符合 PA 指南。体力工作者存在常规补偿效应,他们通过减少闲暇时间的低强度 PA 来补偿职业低强度 PA。非体力工作者并没有补偿他们的职业性长时间久坐,因为这些在闲暇时间仍在继续。
结论 这项研究表明,接受 TKA 的工作患者在手术后 1 年内高度久坐,但大多数患者符合 PA 指南。特别是那些从事非体力工作的人并没有补偿他们的职业性长时间久坐。这强调了需要刺激那些不符合指南和从事非体力工作的 TKA 患者进行 PA。