Page 55 - Petelin, Ana, ur. 2021. Zdravje starostnikov / Health of the Elderly. Zbornik povzetkov z recenzijo / Book of Abstracts. Koper: Založba Univerze na Primorskem/University of Primorska Press
P. 55
ectively measured physical activity, sedentary behavior gibanje in zdravje starejših odraslih | physical activity and health of the elderly
and functional performance before and after lower-limb joint
arthroplasty: a systematic review with meta-analysis
Matic Sašek1, Žiga Kozinc1, Stefan Löfler2, Christian Hofer2, Nejc Šarabon1
1 University of Primorska, Faculty of Health Sciences, Izola, Slovenia
2 Physiko- & Rheumatherapie, Institute for Physical Medicine and Rehabilitation,
3100 St. Pölten, Austria
Introduction. Osteoarthritis (OA) is the most common degenerative musculo-
skeletal disorder affecting mostly older adults. It causes joint pain, limits func-
tional ability, decreases physical activity levels, and leads to increased seden-
tary behavior. To restore function and maintain a healthy lifestyle, hip and knee
arthroplasty are being considered as viable treatment options. Due to pain
relief, increased mobility and function, and higher quality of life after surgery,
higher levels of physical activity (PA) and lower levels of sedentary behavior
(SB) are expected. However, it remains unclear whether and to what extent
patients change their lifestyle postoperatively. To examine the dynamics and
levels of PA and SB before and after joint arthroplasty, meta-analyses of pro-
spective studies were conducted.
Methods. The systematic review with meta-analysis was conducted in accord-
ance with Cochrane Collaboration guidelines. The studies were included in the
analyses based on the specific eligibility criteria. Differences (between patients
and controls or between time points) were expressed as standardized mean
difference (SMD) and corresponding 95 % confidence intervals (CI). Statisti-
cal heterogeneity between studies was assessed by calculating the I2 statistic.
Results. Thirty-five studies met the inclusion criteria and were included in the
review. From 3 to 6 months postoperatively, the 6-min walk score (+90.2 m;
SMD = 0.87) improved largely and statistically significantly (p = 0.008) com-
pared with preoperative values. Between 6 and 9 months after surgery, mod-
erate/vigorous PA was statistically significantly (p = 0.001) increased com-
pared to preoperative values (SMD = 0.32). Light physical activity also tended
to be increased (SMD = 0.14; p = 0.160). Sedentary behavior was similar in
both time periods (SMD = -0.04). Scores on the timed up and go test (-1.91
s; SMD = -0.61) and the 6-min walk (+71.84 m; SMD = 0.62) improved largely
and statistically significantly (p 0.001) compared with preoperative scores. Fi-
nally, 12 or more months after surgery, patients showed increased moderate/
vigorous PA levels (SMD = 0.70; p = 0.001) and number of steps (SMD = 0.52;
+1425 steps/day; p = 0.001).
Discussion and conclusion. Overall, objectively measured PA appears to increase
with time postoperatively. Patients do not reach the preoperative level of PA
until about 6 months, but the values of PA match and then exceed the preoper-
ative level after this time. Functional performance, on the other hand, tends to
increase earlier and continues to develop up to 6 months postoperatively. It is
important to note that although determinants overcome preoperative levels at
6 and 12 months, adequate PA and SB may not be achieved at this time. For this
reason, the problem of long-term inability to further increase PA and reduce
SB should be addressed in the future along with novel rehabilitation protocols.
Keywords: sedentary behavior, physical activity, ageing
53
and functional performance before and after lower-limb joint
arthroplasty: a systematic review with meta-analysis
Matic Sašek1, Žiga Kozinc1, Stefan Löfler2, Christian Hofer2, Nejc Šarabon1
1 University of Primorska, Faculty of Health Sciences, Izola, Slovenia
2 Physiko- & Rheumatherapie, Institute for Physical Medicine and Rehabilitation,
3100 St. Pölten, Austria
Introduction. Osteoarthritis (OA) is the most common degenerative musculo-
skeletal disorder affecting mostly older adults. It causes joint pain, limits func-
tional ability, decreases physical activity levels, and leads to increased seden-
tary behavior. To restore function and maintain a healthy lifestyle, hip and knee
arthroplasty are being considered as viable treatment options. Due to pain
relief, increased mobility and function, and higher quality of life after surgery,
higher levels of physical activity (PA) and lower levels of sedentary behavior
(SB) are expected. However, it remains unclear whether and to what extent
patients change their lifestyle postoperatively. To examine the dynamics and
levels of PA and SB before and after joint arthroplasty, meta-analyses of pro-
spective studies were conducted.
Methods. The systematic review with meta-analysis was conducted in accord-
ance with Cochrane Collaboration guidelines. The studies were included in the
analyses based on the specific eligibility criteria. Differences (between patients
and controls or between time points) were expressed as standardized mean
difference (SMD) and corresponding 95 % confidence intervals (CI). Statisti-
cal heterogeneity between studies was assessed by calculating the I2 statistic.
Results. Thirty-five studies met the inclusion criteria and were included in the
review. From 3 to 6 months postoperatively, the 6-min walk score (+90.2 m;
SMD = 0.87) improved largely and statistically significantly (p = 0.008) com-
pared with preoperative values. Between 6 and 9 months after surgery, mod-
erate/vigorous PA was statistically significantly (p = 0.001) increased com-
pared to preoperative values (SMD = 0.32). Light physical activity also tended
to be increased (SMD = 0.14; p = 0.160). Sedentary behavior was similar in
both time periods (SMD = -0.04). Scores on the timed up and go test (-1.91
s; SMD = -0.61) and the 6-min walk (+71.84 m; SMD = 0.62) improved largely
and statistically significantly (p 0.001) compared with preoperative scores. Fi-
nally, 12 or more months after surgery, patients showed increased moderate/
vigorous PA levels (SMD = 0.70; p = 0.001) and number of steps (SMD = 0.52;
+1425 steps/day; p = 0.001).
Discussion and conclusion. Overall, objectively measured PA appears to increase
with time postoperatively. Patients do not reach the preoperative level of PA
until about 6 months, but the values of PA match and then exceed the preoper-
ative level after this time. Functional performance, on the other hand, tends to
increase earlier and continues to develop up to 6 months postoperatively. It is
important to note that although determinants overcome preoperative levels at
6 and 12 months, adequate PA and SB may not be achieved at this time. For this
reason, the problem of long-term inability to further increase PA and reduce
SB should be addressed in the future along with novel rehabilitation protocols.
Keywords: sedentary behavior, physical activity, ageing
53
