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

Jul 15, 2016BMC musculoskeletal disorders

How Knee Replacement Surgery May Change Daily Activity and Sitting Time in Adults with Osteoarthritis Over Time

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Abstract

Objective measurements of physical activity and sedentary behaviour will be collected from patients with knee osteoarthritis before and after total knee arthroplasty.

Patients with knee osteoarthritis will be assessed one week before, six weeks after, and six months after total knee arthroplasty.
Physical activity and sedentary behaviour will be measured using accelerometers, providing objective data.
Previous studies indicated that physical activity levels do not change significantly post-surgery, but few examined sedentary behaviour.
The study aims to detail patterns of physical activity accumulation and sedentary behaviour in this patient population.
Secondary outcomes include improvements in quality of life and subjective measures such as pain and sleep quality.

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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).

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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

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