Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Study protocol

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

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

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Login to get access

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).
Literature
1.
2.
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.CrossRefPubMed
3.
Jenyo MS, Bamidele JO, Adebimpe WO. Pattern of arthralgia in an urban community in Southwestern Nigeria. Ann Afr Med. 2014;13:65–70.CrossRefPubMed
4.
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.CrossRefPubMed
5.
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.
6.
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.CrossRefPubMed
7.
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.CrossRef
8.
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. e1.CrossRefPubMedPubMedCentral
9.
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.CrossRefPubMedPubMedCentral
10.
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.CrossRefPubMed
11.
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.CrossRefPubMedPubMedCentral
12.
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.CrossRef
13.
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.CrossRef
14.
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.PubMed
15.
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.CrossRefPubMedPubMedCentral
16.
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.CrossRefPubMed
17.
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.CrossRefPubMedPubMedCentral
18.
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.CrossRefPubMedPubMedCentral
19.
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.CrossRefPubMed
20.
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.CrossRefPubMed
21.
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.CrossRefPubMedPubMedCentral
22.
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.CrossRef
23.
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.
24.
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.
25.
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.CrossRefPubMedPubMedCentral
26.
Harding P, Holland AE, Delany C, Hinman RS. Do activity levels increase after total hip and knee arthroplasty? Clin Orthop. 2014;472:1502–11.CrossRefPubMed
27.
28.
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.PubMed
29.
World Health Organization. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010.
30.
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.CrossRef
31.
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.CrossRefPubMed
32.
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.CrossRefPubMed
33.
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.CrossRefPubMed
34.
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.CrossRef
35.
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.CrossRefPubMed
36.
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.CrossRef
37.
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.CrossRefPubMed
38.
Bassett DR. Device-based monitoring in physical activity and public health research. Physiol Meas. 2012;33:1769–83.CrossRefPubMed
39.
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.CrossRefPubMedPubMedCentral
40.
Kahn TL, Schwarzkopf R. Does Total Knee Arthroplasty Affect Physical Activity Levels? Data from the Osteoarthritis Initiative. J Arthroplasty. 2015;30:1521–5.CrossRefPubMed
41.
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.CrossRefPubMedPubMedCentral
42.
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.CrossRefPubMedPubMedCentral
43.
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.CrossRefPubMed
44.
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.CrossRefPubMed
45.
Ryde GC, Gilson ND, Suppini A, Brown WJ. Validation of a novel, objective measure of occupational sitting. J Occup Health. 2012;54:383–6.CrossRefPubMed
46.
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.CrossRefPubMed
47.
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.CrossRefPubMedPubMedCentral
48.
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.CrossRefPubMed
49.
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.CrossRefPubMedPubMedCentral
50.
Bradshaw D, Steyn K. Poverty and chronic disease in South Africa: Medical Research Council. 2001.
51.
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.CrossRefPubMed
52.
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.CrossRefPubMed
53.
Insall JN, Dorr LD, Scott RD, Scott W. Rationale of the Knee Society clinical rating system. Clin Orthop. 1989;248:13–4.
54.
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.CrossRefPubMedPubMedCentral
55.
Dawson J, Carr A. Outcomes evaluation in orthopaedics. J Bone Joint Surg (Br). 2001;83:313–5.CrossRef
56.
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.CrossRefPubMed
57.
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.CrossRefPubMedPubMedCentral
58.
Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30:777–81.CrossRefPubMed
59.
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.
60.
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.CrossRefPubMed
Metadata
Title
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
Authors
Rebecca M. Meiring
Emmanuel Frimpong
Lipalo Mokete
Jurek Pietrzak
Dick Van Der Jagt
Mohammed Tikly
Joanne A. McVeigh
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1141-5

Other articles of this Issue 1/2016

BMC Musculoskeletal Disorders 1/2016 Go to the issue

Research article

Body size from birth to middle age and the risk of hip and knee replacement

Research article

Robust genotyping tool for autosomal recessive type of limb-girdle muscular dystrophies

Research article

Outcome after protected full weightbearing treatment in an orthopedic device in diabetic neuropathic arthropathy (Charcot arthropathy): a comparison of unilaterally and bilaterally affected patients

Research article

UK survey of occupational therapist’s and physiotherapist’s experiences and attitudes towards hip replacement precautions and equipment

Research article

Are online symptoms checkers useful for patients with inflammatory arthritis?

Case report

Basilar impression presenting as intermittent mechanical neck pain: a rare case report