Rationale, design and protocol of a longitudinal study assessing the effect of total knee arthroplasty on habitual physical activity and sedentary behavior in adults with osteoarthritis

Rebecca M Meiring, Emmanuel Frimpong, Lipalo Mokete, Jurek Pietrzak, Dick Van Der Jagt, Mohammed Tikly, Joanne A McVeigh, Rebecca M Meiring, Emmanuel Frimpong, Lipalo Mokete, Jurek Pietrzak, Dick Van Der Jagt, Mohammed Tikly, Joanne A McVeigh

Abstract

Background: Physical activity levels are decreased and sedentary behaviour levels are increased in patients with knee osteoarthritis (OA). However, previous studies have shown that following total knee arthroplasty (TKA), objectively measured physical activity levels do not change compared to before the surgery. Very few studies have objectively assessed sedentary behaviour following TKA. This study aims to assess patterns of objective habitual physical activity and sedentary behaviour in patients with knee OA and to determine whether these change following TKA.

Methods: Patients diagnosed with knee osteoarthritis and scheduled for unilateral primary total knee arthroplasty will be recruited from the Orthopaedic Division at the Charlotte Maxeke Johannesburg Academic Hospital. Eligible participants will have assessments completed one week before the scheduled arthroplasty, six weeks, and six months post-operatively. The primary outcomes are habitual physical activity and sedentary behaviour which will be measured using accelerometry (Actigraph GTX3+ and activPal monitors) at the specific time points. The secondary outcomes will be improvements in osteoarthritis-specific quality of life measures using the following questionnaires: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Knee Society Clinical Rating System (KSS), UCLA activity index; subjective pain scores, and self reported sleep quality.

Discussion: The present study will contribute to the field of musculoskeletal health by providing a rich detailed description of the patterns of accumulation of physical activity and sedentary behaviour in patients with knee OA. These data will contribute to existing knowledge using an objective measurement for the assessment of functional ability after total knee arthroplasty. Although studies have used accelerometry to measure physical activity in knee OA patients, the data provided thus far have not delved into the detailed patterns of how and when physical activity is accumulated before and after TKA. Accurate assessment of physical activity is important for physical activity interventions that target special populations.

Trial registration: NCT02675062 (4 February 2016).

Keywords: Accelerometery; Knee arthroplasty; Osteoarthritis; Physical activity; Sedentary behaviour.

Figures

Fig. 1
Fig. 1
Flow diagram of time points for assessments of habitual physical activity, sedentary behaviour, functional ability, quality of life, general health, mobility and pain questionnaires before and after total knee arthroplasty (TKA)

References

    1. Rousseau JC, Garnero P. Biological markers in osteoarthritis. Bone. 2012;51:265–77. doi: 10.1016/j.bone.2012.04.001.
    1. Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, Kington RS, Lane NE, Nevitt MC, Zhang Y, Sowers M, McAlindon T, Spector TD, Poole AR, Yanovski SZ, Ateshian G, Sharma L, Buckwalter JA, Brandt KD, Fries JF. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000;133:635–46. doi: 10.7326/0003-4819-133-8-200010170-00016.
    1. Jenyo MS, Bamidele JO, Adebimpe WO. Pattern of arthralgia in an urban community in Southwestern Nigeria. Ann Afr Med. 2014;13:65–70. doi: 10.4103/1596-3519.129863.
    1. Ouédraogo D-D, Ntsiba H, Tiendrébéogo Zabsonré J, Tiéno H, Bokossa LIF, Kaboré F, Drabo J. Clinical spectrum of rheumatologic diseases in a department of rheumatology in Ouagadougou (Burkina Faso) Clin Rheumatol. 2014;33:385–9. doi: 10.1007/s10067-013-2455-4.
    1. Oniankitan O, Houzou P, Koffi-Tessio VES, Kakpovi K, Fianyo E, Tagbor KC, Mijiyawa M. Patterns of osteoarthritis in patients attending a teaching hospital clinic. Tunis Médicale. 2009;87:863–6.
    1. Harding PA, Holland AE, Hinman RS, Delany C. Physical activity perceptions and beliefs following total hip and knee arthroplasty: a qualitative study. Physiother Theory Pract. 2015;31:107–13. doi: 10.3109/09593985.2014.959581.
    1. Sandell C-L. A multidisciplinary assessment and intervention for patients awaiting total hip replacement to improve their quality of life. J Orthop Nurs. 2008;12:26–34. doi: 10.1016/j.joon.2007.11.002.
    1. Ma VY, Chan L, Carruthers KJ. Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Arch Phys Med Rehabil. 2014;95:986–95. doi: 10.1016/j.apmr.2013.10.032.
    1. Cubukcu D, Sarsan A, Alkan H. Relationships between pain, function and radiographic findings in osteoarthritis of the knee: a cross-sectional study. Arthritis. 2012;2012:984060. doi: 10.1155/2012/984060.
    1. Peeters GMEE, Pisters MF, Mishra GD, Brown WJ. The influence of long-term exposure and timing of physical activity on new joint pain and stiffness in mid-age women. Osteoarthritis Cartilage. 2015;23:34–40. doi: 10.1016/j.joca.2014.06.040.
    1. Dunlop DD, Song J, Semanik PA, Chang RW, Sharma L, Bathon JM, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Mysiw WJ, Nevitt MC, Hootman JM. Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met? Arthritis Rheum. 2011;63:3372–82. doi: 10.1002/art.30562.
    1. Lee J, Chang RW, Ehrlich-Jones L, Kwoh CK, Nevitt M, Semanik PA, Sharma L, Sohn M-W, Song J, Dunlop DD. Sedentary behavior and physical function: objective evidence from the Osteoarthritis Initiative. Arthritis Care Res. 2015;67:366–73. doi: 10.1002/acr.22432.
    1. Semanik P, Lee J, Manheim L, Dipietro L, Dunlop D, Chang RW. Relationship between accelerometer-based measures of physical activity and the Yale Physical Activity Survey in adults with arthritis. Arthritis Care Res. 2011;63:1766–72. doi: 10.1002/acr.20644.
    1. Holsgaard-Larsen A, Roos EM. Objectively measured physical activity in patients with end stage knee or hip osteoarthritis. Eur J Phys Rehabil Med. 2012;48:577–85.
    1. Farr JN, Going SB, Lohman TG, Rankin L, Kasle S, Cornett M, Cussler E. Physical activity levels in patients with early knee osteoarthritis measured by accelerometry. Arthritis Rheum. 2008;59:1229–36. doi: 10.1002/art.24007.
    1. Buman MP, Winkler EAH, Kurka JM, Hekler EB, Baldwin CM, Owen N, Ainsworth BE, Healy GN, Gardiner PA. Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005-2006. Am J Epidemiol. 2014;179:323–34. doi: 10.1093/aje/kwt292.
    1. Carson V, Ridgers ND, Howard BJ, Winkler EAH, Healy GN, Owen N, Dunstan DW, Salmon J. Light-intensity physical activity and cardiometabolic biomarkers in US adolescents. PLoS One. 2013;8:e71417. doi: 10.1371/journal.pone.0071417.
    1. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev. 2010;38:105–13. doi: 10.1097/JES.0b013e3181e373a2.
    1. Pate RR, McIver K, Dowda M, Brown WH, Addy C. Directly observed physical activity levels in preschool children. J Sch Health. 2008;78:438–44. doi: 10.1111/j.1746-1561.2008.00327.x.
    1. Chastin SFM, Ferriolli E, Stephens NA, Fearon KCH, Greig C. Relationship between sedentary behaviour, physical activity, muscle quality and body composition in healthy older adults. Age Ageing. 2012;41:111–4. doi: 10.1093/ageing/afr075.
    1. Semanik PA, Lee J, Song J, Chang RW, Sohn M-W, Ehrlich-Jones LS, Ainsworth BE, Nevitt MM, Kwoh CK, Dunlop DD. Accelerometer-monitored sedentary behavior and observed physical function loss. Am J Public Health. 2015;105:560–6. doi: 10.2105/AJPH.2014.302270.
    1. Neto F, De EM, Queluz TT, Freire BFA. Physical activity and its association with quality of life in patients with osteoarthritis. Rev Bras Reumatol. 2011;51:544–9. doi: 10.1590/S0482-50042011000600002.
    1. Joubert J, Norman R, Lambert EV, Groenewald P, Schneider M, Bull F, Bradshaw D, South African Comparative Risk Assessment Collaborating Group Estimating the burden of disease attributable to physical inactivity in South Africa in 2000. South Afr Med J. 2007;97(8 Pt 2):725–31.
    1. Brandes M, Ringling M, Winter C, Hillmann A, Rosenbaum D. Changes in physical activity and health-related quality of life during the first year after total knee arthroplasty. Arthritis Care Res. 2011;63:328–34.
    1. Balkau B, Mhamdi L, Oppert J-M, Nolan J, Golay A, Porcellati F, Laakso M, Ferrannini E, EGIR-RISC Study Group Physical activity and insulin sensitivity: the RISC study. Diabetes. 2008;57:2613–8. doi: 10.2337/db07-1605.
    1. Harding P, Holland AE, Delany C, Hinman RS. Do activity levels increase after total hip and knee arthroplasty? Clin Orthop. 2014;472:1502–11. doi: 10.1007/s11999-013-3427-3.
    1. Berenbaum F. Targeted therapies in osteoarthritis: a systematic review of the trials on . Best Pract Res Clin Rheumatol. 2010;24:107–19. doi: 10.1016/j.berh.2009.08.007.
    1. Van Manen MD, Nace J, Mont MA. Management of primary knee osteoarthritis and indications for total knee arthroplasty for general practitioners. J Am Osteopath Assoc. 2012;112:709–15.
    1. World Health Organization . Global recommendations on physical activity for health. Geneva: World Health Organization; 2010.
    1. Stenquist DS, Elman SA, Davis AM, Bogart LM, Brownlee SA, Sanchez ES, Santiago A, Ghazinouri R, Katz JN. Physical activity and experience of total knee replacement in patients one to four years postsurgery in the dominican republic: a qualitative study. Arthritis Care Res. 2015;67:65–73. doi: 10.1002/acr.22367.
    1. Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster J-Y. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004;86–A:963–74.
    1. Salaffi F, Carotti M, Grassi W. Health-related quality of life in patients with hip or knee osteoarthritis: comparison of generic and disease-specific instruments. Clin Rheumatol. 2005;24:29–37. doi: 10.1007/s10067-004-0965-9.
    1. Vissers MM, Bussmann JB, de Groot IB, Verhaar JAN, Reijman M. Physical functioning four years after total hip and knee arthroplasty. Gait Posture. 2013;38:310–5. doi: 10.1016/j.gaitpost.2012.12.007.
    1. Hoogeboom TJ, den Broeder AA, de Bie RA, van den Ende CHM. Longitudinal impact of joint pain comorbidity on quality of life and activity levels in knee osteoarthritis: data from the Osteoarthritis Initiative. Rheumatol Oxf Engl. 2013;52:543–6. doi: 10.1093/rheumatology/kes314.
    1. Muraki S, Akune T, Oka H, En-yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Tokimura F, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N. Association of radiographic and symptomatic knee osteoarthritis with health-related quality of life in a population-based cohort study in Japan: the ROAD study. Osteoarthr Cartil. 2010;18:1227–34. doi: 10.1016/j.joca.2010.06.001.
    1. Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB. Does total knee replacement restore normal knee function? Clin Orthop. 2005;431:157–65. doi: 10.1097/01.blo.0000150130.03519.fb.
    1. Harris TJ, Owen CG, Victor CR, Adams R, Ekelund U, Cook DG. A comparison of questionnaire, accelerometer, and pedometer: measures in older people. Med Sci Sports Exerc. 2009;41:1392–402. doi: 10.1249/MSS.0b013e31819b3533.
    1. Bassett DR. Device-based monitoring in physical activity and public health research. Physiol Meas. 2012;33:1769–83. doi: 10.1088/0967-3334/33/11/1769.
    1. Paxton RJ, Melanson EL, Stevens-Lapsley JE, Christiansen CL. Physical activity after total knee arthroplasty: A critical review. World J Orthop. 2015;6:614–22. doi: 10.5312/wjo.v6.i8.614.
    1. Kahn TL, Schwarzkopf R. Does Total Knee Arthroplasty Affect Physical Activity Levels? Data from the Osteoarthritis Initiative. J Arthroplasty. 2015;30:1521–5. doi: 10.1016/j.arth.2015.03.016.
    1. de Groot IB, Bussmann HJ, Stam HJ, Verhaar JA. Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthop. 2008;466:2201–8. doi: 10.1007/s11999-008-0315-3.
    1. Tsonga T, Kapetanakis S, Papadopoulos C, Papathanasiou J, Mourgias N, Georgiou N, Fiska A, Kazakos K. Evaluation of improvement in quality of life and physical activity after total knee arthroplasty in Greek elderly women. Open Orthop J. 2011;5:343–7. doi: 10.2174/1874325001105010343.
    1. Walker DJ, Heslop PS, Chandler C, Pinder IM. Measured ambulation and self‐reported health status following total joint replacement for the osteoarthritic knee. Rheumatology. 2002;41:755–8. doi: 10.1093/rheumatology/41.7.755.
    1. Kozey-Keadle S, Libertine A, Lyden K, Staudenmayer J, Freedson PS. Validation of wearable monitors for assessing sedentary behavior. Med Sci Sports Exerc. 2011;43:1561–7. doi: 10.1249/MSS.0b013e31820ce174.
    1. Ryde GC, Gilson ND, Suppini A, Brown WJ. Validation of a novel, objective measure of occupational sitting. J Occup Health. 2012;54:383–6. doi: 10.1539/joh.12-0091-BR.
    1. Godfrey A, Culhane KM, Lyons GM. Comparison of the performance of the activPAL Professional physical activity logger to a discrete accelerometer-based activity monitor. Med Eng Phys. 2007;29:930–4. doi: 10.1016/j.medengphy.2006.10.001.
    1. Tonelli SM, Rakel BA, Cooper NA, Angstom WL, Sluka KA. Women with knee osteoarthritis have more pain and poorer function than men, but similar physical activity prior to total knee replacement. Biol Sex Differ. 2011;2:12. doi: 10.1186/2042-6410-2-12.
    1. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29:1039–49. doi: 10.1002/art.1780290816.
    1. Dunstan DW, Kingwell BA, Larsen R, Healy GN, Cerin E, Hamilton MT, Shaw JE, Bertovic DA, Zimmet PZ, Salmon J, Owen N. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care. 2012;35:976–83. doi: 10.2337/dc11-1931.
    1. Bradshaw D, Steyn K. Poverty and chronic disease in South Africa: Medical Research Council. 2001.
    1. Stevens-Lapsley JE, Schenkman ML, Dayton MR. Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. PM R. 2011;3:541–9. doi: 10.1016/j.pmrj.2011.03.002.
    1. Lygre SHL, Espehaug B, Havelin LI, Vollset SE, Furnes O. Does patella resurfacing really matter? Pain and function in 972 patients after primary total knee arthroplasty. Acta Orthop. 2010;81:99–107. doi: 10.3109/17453671003587069.
    1. Insall JN, Dorr LD, Scott RD, Scott W. Rationale of the Knee Society clinical rating system. Clin Orthop. 1989;248:13–4.
    1. Xie F, Lo N-N, Pullenayegum EM, Tarride J-E, O’Reilly DJ, Goeree R, Lee H-P. Evaluation of health outcomes in osteoarthritis patients after total knee replacement: a two-year follow-up. Health Qual Life Outcomes. 2010;8:87. doi: 10.1186/1477-7525-8-87.
    1. Dawson J, Carr A. Outcomes evaluation in orthopaedics. J Bone Joint Surg (Br) 2001;83:313–5. doi: 10.1302/0301-620X.83B3.12148.
    1. Naal FD, Impellizzeri FM, Leunig M. Which is the best activity rating scale for patients undergoing total joint arthroplasty? Clin Orthop. 2009;467:958–65. doi: 10.1007/s11999-008-0358-5.
    1. Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, Troiano RP. Amount of time spent in sedentary behaviors in the United States, 2003-2004. Am J Epidemiol. 2008;167:875–81. doi: 10.1093/aje/kwm390.
    1. Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30:777–81. doi: 10.1097/00005768-199805000-00021.
    1. Edwardson CL, Winkler EAH, Bodicoat DH, Yates T, Davies MJ, Dunstan DW, Healy GN. Considerations when using the activPAL monitor in field based research with adult populations. J Sport Health Sci. 2016. In Press.
    1. Gianoudis J, Bailey CA, Daly RM. Associations between sedentary behaviour and body composition, muscle function and sarcopenia in community-dwelling older adults. Osteoporos Int. 2015;26:571–9. doi: 10.1007/s00198-014-2895-y.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅