Everyday Physical Activity and Sedentary Behavior After Total Joint Arthroplasty: Do Patients and Partners Develop an Active Lifestyle?

Continuous data capture of gait and mobility metrics using wearable devices for postoperative monitoring in common elective orthopaedic procedures of the hip, knee, and spine: a scoping review

BACKGROUND

Surgical procedures involving the hip, knee, or spine represent a majority of orthopaedic procedures performed electively in the health care system. Postoperative care is a key aspect of surgery and mobilisation without injury is the primary objective. Recent advances in wearable technologies allow objective evaluation of walking metrics to inform and guide postoperative care following orthopaedic surgery.

PURPOSE

The aim of this scoping review is to explore current applications of wearable devices, objective data capture and gait analysis in monitoring postoperative recovery following commonly performed elective orthopaedic procedures of the hip, knee and spine.

METHODS

A search against pre-defined criteria was performed on the following scientific databases from date of inception to February 28th, 2021: Medline (via OvidSP), Embase (via OvidSP) and Cochrane Library (via CENTRAL). Data were collected according to a predetermined checklist including study participants, surgery, wearable device (model), sensor location, and monitoring parameters such as mobility metrics, monitoring timepoints and monitoring duration for each study included in our review. Quality was assessed independently using the Newcastle Ottawa Scale (NOS).

CONCLUSIONS

To our knowledge, this is the first review of wearable monitoring (of postoperative recovery) following hip, knee and spine surgery. Patients undergoing elective orthopaedic procedures may benefit from wearable monitoring of their walking health and mobility metrics.

Effect of the knee replacement surgery on activity level based on ActivPAL: a systematic review and meta-analysis study

Background

The knee replacement (KR) surgery aims to restore the activity level and reduce the risk of experiencing disabilities. The outcomes of this surgery are evaluated mainly with subjective tools or low validity objective tools. However, the effect of the surgery on activity level using high validity objective accelerometer is still in question.

Methods

A systematic review and meta-analysis were conducted to evaluate the benefit of KR surgery alone to enhance physical activity recommendations based on high validity accelerometer. Two independent reviewers evaluated five electronic databases (Cochrane-Central-Register-of-Controlled Trials, EMBASE, PubMed, Web of Science, and Scopus) to find relative studies between January 2000 and October 2021. The quality assessments and risk of bias assessments were examined.

Results

Three articles were included with 202 participants (86 males, 116 females), with an average age of 64 years and an average 32 kg/m² body mass index. The results found that the number of steps was significantly improved up to 36.35 and 45.5% after 6-months and 1-year of the surgery, respectively. However, these changes did not meet the recommended activity level guideline and could be related to the patients’ health status and their activity level before the surgery. No significant changes were seen in sedentary time, standing time, and upright time after 6-months and 1-year follow-ups. Heterogeneity among studies was low to moderate (0–63%).

Conclusion

Knee replacement surgery is an effective treatment for improving patients’ quality of life with severe knee injuries. However, various factors impact the success of surgical and achieving maximum benefit of the surgery. One factor, sedentary time, can be reduced by implementing pre-and post-surgery exercise or physical activity recommendations. Further studies are needed to understand the benefit of surgery with or without rehabilitation assessed using high validity monitors.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-022-05531-2.

Active With Whom? Examining the Social Context of Physical Activity in Individuals After Stroke and Their Partners

Engaging in regular moderate-to-vigorous intensity physical activity (MVPA) is crucial to reduce future health risk for individuals living with the effects of a stroke and their partners. Although numerous studies point to the importance of social factors in physical activity engagement, little is known about with whom individuals after stroke and their partners engage in physical activity with and whether different physical activity companions are uniquely associated with MVPA. Eighty-nine community-dwelling individuals after stroke (M_age = 68.64, SD = 10.44; 74% male) and 83 partners (M_age = 66.04, SD = 9.91; 24% male) completed 14 consecutive days of daily life assessments that included wearing physical activity monitors (accelerometers) and self-reporting physical activity companions (n = 1,961 days). Results show that average levels of MVPA were correlated between partners (r = 0.38), as were day-to-day MVPA fluctuations (r = 0.34). Importantly, for individuals after stroke, being active with their partner, but not with any other physical activity companion, was linked with elevated daily MVPA. In contrast, for partners of individuals after stroke, engaging in physical activity with a variety of different companions (partner, other family member, friend, colleague) was each associated with higher MVPA in daily life. For both individuals after stroke and their partners being active by oneself (without a companion) on a given day was not associated with elevated MVPA. Findings suggest that interventions that promote physical activity engagement should consider the role of meaningful others, with the partner being particularly key for individuals living with chronic health conditions.