Lošťák J, Gába A, Dygrýn J, Baláž Ĺ, Štefelová N, Gallo J
Department of Orthopedics, University Hospital Olomouc, Czech Republic.
Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.
Acta Chir Orthop Traumatol Cech. 2022;89(1):9-15.
PURPOSE OF THE STUDY This study aims to describe and analyze the age differences in the 24-hour movement behavior patterns among a sample of adults and older adults with end-stage knee osteoarthritis referred for total knee arthroplasty (TKA). MATERIAL AND METHODS A total of 86 patients referred for TKA were included in this study. Sleep duration, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) were assessed using multi-day 24-hour raw data from wrist-worn accelerometers. Compositional data analysis was used to analyze the differences between the age categories. RESULTS On average (SD), the adults were 59.0 (± 4.9) years; 63% female. The older adults were 72.4 (± 5.5) years; 58% female. The adults reached 23.9 milli-gravitational units (mg) as a mean acceleration over the whole day; 34% (8.1 h/day) of the time was classified as sleep, 48.9% (11.7 h/day) as SB, 12.1% (2.9 h/day) as LPA, and 5.1% (72.9 min/day) as MVPA. The older adults reached 21.3 mg; 35.2% (8.4 h/day) of the time was classified as sleep, 50.4% (12.1 h/day) as SB, 11.3% (2.7 h/day) as LPA, and 3.1% (44.9 min/day) as MVPA. Compared with the older adults, the proportion of time spent in total MVPA (P = 0.008) and MVPA bouts of ≥1 min were greater (P ≤ 0.028) in the adult group, while the proportion of time spent in total SB was lower (P = 0.045). No age difference was found for the proportion of time spent asleep. DISCUSSION Sleep, SB, and PA are exclusive and exhaustive parts of the overall 24-h day. Using accelerometer-based measures of 24-hour movement behavior to describe these behaviors more accurately is crucial for a better understanding of patients with end-stage KOA. CONCLUSIONS Our findings suggest that the adults and older adults referred for TKA are physically active despite suffering from severe knee osteoarthritis. Such a high level of physical activity may be difficult to increase by TKA postoperatively. If replicated by other studies, 24-hour movement behaviors should be implemented among the examinations required before TKA. Key words: knee osteoarthritis, accelerometer, sedentary behaviour, physical activity, sleep, 24-hour lifestyle behaviour.
研究目的 本研究旨在描述和分析因终末期膝骨关节炎接受全膝关节置换术（TKA）的成年人及老年人样本在24小时运动行为模式上的年龄差异。
材料与方法 本研究共纳入86例因TKA前来就诊的患者。使用腕部佩戴式加速度计多日采集的24小时原始数据，评估睡眠时间、久坐行为（SB）、轻度身体活动（LPA）和中度至剧烈身体活动（MVPA）。采用成分数据分析来分析不同年龄组之间的差异。
结果 成年人平均（标准差）年龄为59.0（±4.9）岁；女性占63%。老年人平均年龄为72.4（±5.5）岁；女性占58%。成年人全天平均加速度达到23.9毫重力单位（mg）；34%（8.1小时/天）的时间被归类为睡眠，48.9%（11.7小时/天）为SB，12.1%（2.9小时/天）为LPA，5.1%（72.9分钟/天）为MVPA。老年人平均加速度为21.3 mg；35.2%（8.4小时/天）的时间被归类为睡眠，50.4%（12.1小时/天）为SB，11.3%（2.7小时/天）为LPA, 3.1%（44.9分钟/天）为MVPA。与老年人相比，成年组在总MVPA中花费的时间比例（P = 0.008）以及≥1分钟的MVPA发作次数比例更高（P≤0.028），而在总SB中花费的时间比例更低（P = 0.045）。睡眠时间比例未发现年龄差异。
讨论 睡眠、SB和身体活动是全天24小时相互排斥且详尽无遗的组成部分。使用基于加速度计的24小时运动行为测量方法更准确地描述这些行为，对于更好地了解终末期膝骨关节炎患者至关重要。
结论 我们的研究结果表明，因TKA前来就诊的成年人及老年人尽管患有严重的膝骨关节炎，但身体仍较为活跃。术后通过TKA可能难以进一步提高这种高水平的身体活动。如果其他研究能重复本研究结果，那么在TKA术前的检查中应纳入24小时运动行为评估。
膝骨关节炎；加速度计；久坐行为；身体活动；睡眠；24小时生活方式行为
