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19-09-2017 | Rheumatology | News | Article

Physical activity promotion needed after total knee or hip replacement

medwireNews: Changing sedentary behavior needs to be a focus for patients who undergo total knee or hip joint replacement, US researchers maintain.

Despite substantial improvements in pain, physical function, and quality of life following surgery, their meta-analysis found no significant increases in physical activity after 6 months, and only modest increases after a year.

Adam Goode (Duke University School of Medicine, Durham, North Carolina) and co-workers say the reasons behind the lack of increase in physical activity are unknown.

However, they speculate that it “may be behavioral in nature as sedentary behavior is difficult to change.”

The team suggests: “Moving forward, it is important to consider strategies to actively promote changes in [physical activity], such as cognitive behavioral interventions and incorporation of psychosocial models for behavior change early following joint replacement.”

Total hip and knee arthroplasty are among the most common elective surgeries in the US, the researchers point out, and 11 million Americans will be expected to have undergone these procedures by 2030.

Noting that regular physical activity is essential to decrease the risk for comorbidities in patients with osteoarthritis and is associated with many positive health outcomes, they conducted a meta-analysis of seven cohort studies.

Together, the studies included a total of 336 participants in whom physical activity was measured using an accelerometer from before to at least 2 months after total knee or hip arthroplasty.

The team found that physical activity did not significantly increase at 6 months after total joint replacement, irrespective of whether it was the knee or hip, while at 12 months afterwards there was a small to moderate increase in physical activity.

These same studies showed large reductions in pain and increases in both physical function and quality of life.

Reporting in Arthritis Care and Research, Hammett et al speculate: “Behavior modification therapy provided to patients before and following joint replacement surgery may help to impact the learned behaviors associated with a sedentary lifestyle.

“Treatment may include addressing patient willingness to change, recognizing individual barriers to increasing physical activity, and identifying motivating factors.”

They note that using an accelerometer to provide feedback to patients has shown significant benefits during interventions to increase physical activity.

By Anita Chakraverty

medwireNews is an independent medical news service provided by Springer Healthcare. © 2017 Springer Healthcare part of the Springer Nature group