Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2022

01-12-2022 | Research

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

Authors: Huda Alfatafta, Mahmoud Alfatafta, David Onchonga, Sahar Hammoud, Haitham Khatatbeh, Lu Zhang, Imre Boncz, Szimonetta Lohner, Bálint Molics

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Login to get access

Abstract

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.
Appendix
Available only for authorised users
Literature
2.
go back to reference Lingard EA, Sledge CB, Learmonth ID, Group KO. Patient expectations regarding total knee arthroplasty: differences among the United States, United Kingdom, and Australia. JBJS. 2006;88(6):1201–1207. Lingard EA, Sledge CB, Learmonth ID, Group KO. Patient expectations regarding total knee arthroplasty: differences among the United States, United Kingdom, and Australia. JBJS. 2006;88(6):1201–1207.
3.
4.
go back to reference Hoorntje A, Witjes S, Kuijer PPF, Bussmann JB, Horemans HL, Kerkhoffs GM, et al. Does activity-based rehabilitation with goal attainment scaling increase physical activity among younger knee arthroplasty patients? Results from the randomized controlled ACTION trial. J Arthroplast. 2020;35(3):706–11.CrossRef Hoorntje A, Witjes S, Kuijer PPF, Bussmann JB, Horemans HL, Kerkhoffs GM, et al. Does activity-based rehabilitation with goal attainment scaling increase physical activity among younger knee arthroplasty patients? Results from the randomized controlled ACTION trial. J Arthroplast. 2020;35(3):706–11.CrossRef
7.
8.
go back to reference Collins NJ, Roos EM. Patient-reported outcomes for total hip and knee arthroplasty: commonly used instruments and attributes of a “good” measure. Clin Geriatr Med. 2012;28(3):367–94.CrossRef Collins NJ, Roos EM. Patient-reported outcomes for total hip and knee arthroplasty: commonly used instruments and attributes of a “good” measure. Clin Geriatr Med. 2012;28(3):367–94.CrossRef
10.
go back to reference Arnold JB, Walters JL, Ferrar KE. Does physical activity increase after total hip or knee arthroplasty for osteoarthritis? A systematic review. J Orthopaedic Sports Physical Ther. 2016;46(6):431–42.CrossRef Arnold JB, Walters JL, Ferrar KE. Does physical activity increase after total hip or knee arthroplasty for osteoarthritis? A systematic review. J Orthopaedic Sports Physical Ther. 2016;46(6):431–42.CrossRef
11.
go back to reference Almeida GJ, Khoja SS, Piva SR. Physical activity after total joint arthroplasty: a narrative review. Open Access J Sports Med. 2018;9:55.CrossRef Almeida GJ, Khoja SS, Piva SR. Physical activity after total joint arthroplasty: a narrative review. Open Access J Sports Med. 2018;9:55.CrossRef
12.
go back to reference Hammett T, Simonian A, Austin M, Butler R, Allen KD, Ledbetter L, et al. Changes in physical activity after total hip or knee arthroplasty: a systematic review and meta-analysis of six-and twelve-month outcomes. Arthritis Care Res. 2018;70(6):892–901.CrossRef Hammett T, Simonian A, Austin M, Butler R, Allen KD, Ledbetter L, et al. Changes in physical activity after total hip or knee arthroplasty: a systematic review and meta-analysis of six-and twelve-month outcomes. Arthritis Care Res. 2018;70(6):892–901.CrossRef
13.
go back to reference Edwardson CL, Winkler EA, Bodicoat DH, Yates T, Davies MJ, Dunstan DW, et al. Considerations when using the activPAL monitor in field-based research with adult populations. J Sport Health Sci. 2017;6(2):162–78.CrossRef Edwardson CL, Winkler EA, Bodicoat DH, Yates T, Davies MJ, Dunstan DW, et al. Considerations when using the activPAL monitor in field-based research with adult populations. J Sport Health Sci. 2017;6(2):162–78.CrossRef
14.
go back to reference Grant PM, Dall PM, Mitchell SL, Granat MH. Activity-monitor accuracy in measuring step number and cadence in community-dwelling older adults. J Aging Phys Act. 2008;16(2):201–14.CrossRef Grant PM, Dall PM, Mitchell SL, Granat MH. Activity-monitor accuracy in measuring step number and cadence in community-dwelling older adults. J Aging Phys Act. 2008;16(2):201–14.CrossRef
15.
go back to reference Grant PM, Ryan CG, Tigbe WW, Granat MH. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med. 2006;40(12):992–7.CrossRef Grant PM, Ryan CG, Tigbe WW, Granat MH. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med. 2006;40(12):992–7.CrossRef
16.
go back to reference Yang C-C, Hsu Y-L. A review of accelerometry-based wearable motion detectors for physical activity monitoring. Sensors. 2010;10(8):7772–88.CrossRef Yang C-C, Hsu Y-L. A review of accelerometry-based wearable motion detectors for physical activity monitoring. Sensors. 2010;10(8):7772–88.CrossRef
17.
go back to reference Godfrey A, Culhane K, Lyons G. Comparison of the performance of the activPAL™ professional physical activity logger to a discrete accelerometer-based activity monitor. Med Eng Phys. 2007;29(8):930–4.CrossRef Godfrey A, Culhane K, Lyons G. Comparison of the performance of the activPAL™ professional physical activity logger to a discrete accelerometer-based activity monitor. Med Eng Phys. 2007;29(8):930–4.CrossRef
18.
go back to reference Aminian S, Hinckson EA. Examining the validity of the ActivPAL monitor in measuring posture and ambulatory movement in children. Int J Behav Nutr Phys Act. 2012;9(1):1–9.CrossRef Aminian S, Hinckson EA. Examining the validity of the ActivPAL monitor in measuring posture and ambulatory movement in children. Int J Behav Nutr Phys Act. 2012;9(1):1–9.CrossRef
20.
go back to reference Kim Y, Barry VW, Kang M. Validation of the ActiGraph GT3X and activPAL accelerometers for the assessment of sedentary behavior. Meas Phys Educ Exerc Sci. 2015;19(3):125–37.CrossRef Kim Y, Barry VW, Kang M. Validation of the ActiGraph GT3X and activPAL accelerometers for the assessment of sedentary behavior. Meas Phys Educ Exerc Sci. 2015;19(3):125–37.CrossRef
22.
go back to reference Kahn TL, Schwarzkopf R. Does total knee arthroplasty affect physical activity levels? Data from the osteoarthritis initiative. J Arthroplast. 2015;30(9):1521–5.CrossRef Kahn TL, Schwarzkopf R. Does total knee arthroplasty affect physical activity levels? Data from the osteoarthritis initiative. J Arthroplast. 2015;30(9):1521–5.CrossRef
23.
go back to reference Granat M, Williams A, Johnson DS, Jones R. Does free-living physical activity improve one-year following total knee arthroplasty in patients with osteoarthritis: a prospective study. Osteoarthritis Cartilage Open. 2020;2(3)100065. Granat M, Williams A, Johnson DS, Jones R. Does free-living physical activity improve one-year following total knee arthroplasty in patients with osteoarthritis: a prospective study. Osteoarthritis Cartilage Open. 2020;2(3)100065.
24.
go back to reference Haskell WL, Lee I-M, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):081. Haskell WL, Lee I-M, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):081.
25.
go back to reference Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj. 2021;372:103–12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj. 2021;372:103–12.
30.
go back to reference Pellegrini CA, Lee J, DeVivo KE, Harpine CE, Del Gaizo DJ, Wilcox S. Reducing sedentary time using an innovative mHealth intervention among patients with total knee replacement: rationale and study protocol. Contemporary clinical trials Communications. 2021;100810. https://doi.org/10.1016/j.conctc.2021.100810. Pellegrini CA, Lee J, DeVivo KE, Harpine CE, Del Gaizo DJ, Wilcox S. Reducing sedentary time using an innovative mHealth intervention among patients with total knee replacement: rationale and study protocol. Contemporary clinical trials Communications. 2021;100810. https://​doi.​org/​10.​1016/​j.​conctc.​2021.​100810.
31.
go back to reference Lützner C, Kirschner S, Lützner J. Patient activity after TKA depends on patient-specific parameters. Clin Orthop Relat Res. 2014;472(12):3933–40.CrossRef Lützner C, Kirschner S, Lützner J. Patient activity after TKA depends on patient-specific parameters. Clin Orthop Relat Res. 2014;472(12):3933–40.CrossRef
32.
go back to reference Frimpong E, van der Jagt DR, Mokete L, Pietrzak J, Kaoje YS, Smith A, et al. Improvements in objectively measured activity behaviors do not correlate with improvements in patient-reported outcome measures following total knee arthroplasty. J Arthroplasty. 2020;35(3):712–9. e4. Frimpong E, van der Jagt DR, Mokete L, Pietrzak J, Kaoje YS, Smith A, et al. Improvements in objectively measured activity behaviors do not correlate with improvements in patient-reported outcome measures following total knee arthroplasty. J Arthroplasty. 2020;35(3):712–9. e4.
33.
go back to reference de Groot IB, Bussmann HJ, Stam HJ, Verhaar JA. Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthopaedics Related Res. 2008;466(9):2201. de Groot IB, Bussmann HJ, Stam HJ, Verhaar JA. Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthopaedics Related Res. 2008;466(9):2201.
35.
go back to reference Kalisch T, Horst F, Gosheger G, Theil C, Seeber L, Moellenbeck B. Everyday physical activity and sedentary behavior after Total joint Arthroplasty: do patients and partners develop an active lifestyle? Clin Interv Aging. 2021;16:403.CrossRef Kalisch T, Horst F, Gosheger G, Theil C, Seeber L, Moellenbeck B. Everyday physical activity and sedentary behavior after Total joint Arthroplasty: do patients and partners develop an active lifestyle? Clin Interv Aging. 2021;16:403.CrossRef
36.
go back to reference Harding P, Holland AE, Delany C, Hinman RS. Do activity levels increase after total hip and knee arthroplasty? Clin Orthop Relat Res. 2014;472(5):1502–11.CrossRef Harding P, Holland AE, Delany C, Hinman RS. Do activity levels increase after total hip and knee arthroplasty? Clin Orthop Relat Res. 2014;472(5):1502–11.CrossRef
37.
go back to reference Moellenbeck B, Horst F, Gosheger G, Theil C, Seeber L, Kalisch T. Does total hip or knee arthroplasty have an effect on the patients’ functional or behavioral outcome and health-related quality of life of the affected partners? J Arthroplast. 2021;36(3):885–91.CrossRef Moellenbeck B, Horst F, Gosheger G, Theil C, Seeber L, Kalisch T. Does total hip or knee arthroplasty have an effect on the patients’ functional or behavioral outcome and health-related quality of life of the affected partners? J Arthroplast. 2021;36(3):885–91.CrossRef
Metadata
Title
Effect of the knee replacement surgery on activity level based on ActivPAL: a systematic review and meta-analysis study
Authors
Huda Alfatafta
Mahmoud Alfatafta
David Onchonga
Sahar Hammoud
Haitham Khatatbeh
Lu Zhang
Imre Boncz
Szimonetta Lohner
Bálint Molics
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-05531-2

Other articles of this Issue 1/2022

BMC Musculoskeletal Disorders 1/2022 Go to the issue