Abstract
Background
The recovery in physical activity (PA) following telerehabilitation after hip and knee arthroplasty (TKA-THA) is not often examined. A better knowledge the process of PA recovery is necessary because it is affected by numerous variables, such as gender, age, or physical condition.
Objectives
To evaluate PA recovery each week for 3 months following TKA-THA. To determine the perioperative factors that can assist in predicting PA recovery after 3 months.
Methods
From the first week of surgery to three months after surgery, the patients were able to wear an exercise tracker for a continuous period. Each patient received individualized daily workouts and feedback via tablets. After and prior to surgery, the patient’s reported outcomes of painkiller Buy Oxycontin-online, symptoms and activities of daily living as well as the quality of their lives were documented. One-way ANOVA was utilized to determine the effect of time on the number of steps for each week post-operatively. To estimate the step count after 3 months after surgery using a reverse multi-linear regression model was employed.
Results
Patients reached their preoperative PA levels at week 7, but with little or no improvement at 3 months after surgery. Step count before surgery as well as the days that patients used crutches as well as preoperative symptoms contributed to about 35% variation of the step count at 3 months.
Conclusion
This patient group receiving rehabilitation via telerehabilitation had reached their preoperative PA levels at 7 weeks post-surgery, with no improvement in the following five weeks. A 3 month-old PA reading can be predicted based on preoperative step count, the duration of use of crutches, and pre-operative signs.
Introduction
THA or total hip arthritis (THA) also known as total knee joint arthroplasty (TKA) are surgical procedures for patients suffering from end-stage osteoarthritis (OA). In Belgium there were 49,771 knee and hip arthroplasties were carried out in the year 2016 (26736 THA and 230335 TKA1) and in the US the number of surgeries is predicted to grow significantly through 2030.2 3,
Physical Activity (PA) refers to any activity performed by muscles of the skeleton that demands energy. PA is beneficial to mental, physical and social health, and it is a significant issue to public health policies.5 The recovery of PA during the first postoperative stage isn’t fully understood as research studies have revealed contradicting findings. Schotanus and al.6 found they observed that PA post TKA increases dramatically during the initial four days postoperatively and improves further towards the 6-week evaluation, but it was still below preoperative levels. However, Twiggs et al.7 recorded steps similar to those of preoperative times after the 6 week postoperative point. In the later stages of the recovery process, a comprehensive review conducted by Arnold and colleagues. (373 patients) discovered that, compared to before surgery, there were no changes in PA after six months following THA and TKA however there are significant changes one year postoperatively.8 While THA and TKA can reduce pain Buy Oxycontin Online and improve function, 4 9 it’s not known if PA also improves when compared to the prior to surgery level.8 Furthermore, the PA after surgery is lower than that of patients who do not have OA.10
Assessment of PA can be done by using validated self-report questionnaires.11 While these questionnaires are useful, they are susceptible to recollection by the patient and, consequently, recall bias.12 Additionally, the change in the PA following joint arthroplasty is usually considered the result of a “snapshot”, at two or three times, but fails to accurately reflect the complexity of recovery. Paxton et al. suggested the use fitness trackers as accelerometry-based measurement at various post-surgical times during rehabilitation.10 They allow the objective measurement of PA over extended periods of time, and calculate the number of steps walked per day.13 They can collect detailed data on PA that physical therapists are unable to observe.14
While the best approach to treatment after TKA and THA is not yet clear however, telerehabilitation has shown its ability to boost the recovery of patients with a cost-effective way.15 16-17 Telerehabilitation is believed to be efficient and comparable to traditional rehabilitation to improve physical functioning and pain.18 Technologies that combine the use of fitness trackers and tablets could be beneficial for rehabilitation via telemedicine and monitoring of everyday activity.19
To devise effective strategies to enhance the PA following knee and hip arthroplasties, it is essential to fully study the factors that can influence preoperative changes in PA following surgery.8 A few studies have examined the impact of predictors like gender and age on PA in patients suffering from hip or knee OA.20 21 Female gender, elderly age and a low quality of life20 have been linked to low levels of PA. To the best of our understanding, research that examines the effect of predictors on the recovery rate after TKA or THA have been scarce.22 Twiggs et al.7 recently discovered a gender-related effect on PA in the period prior to surgery however not at 1 or six weeks after TKA. The systematic reviews they conducted, Veenhof and al.20 observed contradictory evidence of the connection between gender, age and the level of recovery PA in knee OA. Twiggs et al.7 have demonstrated that the quality of life, BMI (BMI) and preoperative step count were associated with the rate of PA recovery for patients six weeks after TKA.7 A more thorough understanding of the connection between gender, age and type of surgery for pain relief Buy Oxycontin-online, as well as PA levels and the recovery of PA after surgery can help create telerehabilitation programs that are tailored to patients’ requirements.
The purpose of the study was to determine PA recovery week-to-week following TKA or THA surgery, separating female and male patients who were treated via telerehabilitation.To study possible predictors of PA recovery each week for up to 3 months following the procedure.
Section A few snippets
Study design
The data used in the longitudinal cohort study comes taken from the MORE Clinical Study (Clinical Trial Number: B117201732334) which was a pilot study as part of a nationwide program designed to establish a framework for mobile health applications within the Belgium healthcare system.23 The study involved patients were monitored following hip or knee arthroplasty using an application for mobile health available commercially (Move Up cvba Belgium) for three months following surgery. The protocol was carried out as well as recorded and reported according to
