Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trial

Objective: This pilot trial examined a Physical Activity and Symmetry (PAS) intervention focused on common deficits of physical inactivity and joint loading asymmetry following total knee arthroplasty (TKA). Design: Participants (n ​= ​60) were enrolled during routine physical therapy (PT) following...

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Main Authors: Robin M. Queen, Liubov Arbeeva, Daniel N. Bracey, Derek Hales, Carla Hill, Katie F. Huffman, Todd A. Schwartz, Kelli D. Allen
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Osteoarthritis and Cartilage Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2665913124001018
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author Robin M. Queen
Liubov Arbeeva
Daniel N. Bracey
Derek Hales
Carla Hill
Katie F. Huffman
Todd A. Schwartz
Kelli D. Allen
author_facet Robin M. Queen
Liubov Arbeeva
Daniel N. Bracey
Derek Hales
Carla Hill
Katie F. Huffman
Todd A. Schwartz
Kelli D. Allen
author_sort Robin M. Queen
collection DOAJ
description Objective: This pilot trial examined a Physical Activity and Symmetry (PAS) intervention focused on common deficits of physical inactivity and joint loading asymmetry following total knee arthroplasty (TKA). Design: Participants (n ​= ​60) were enrolled during routine physical therapy (PT) following TKA and randomized to the PAS intervention or an attention (ATT) control group. The PAS intervention included physical activity counseling and balance exercise to address joint loading symmetry; content was delivered during 2 sessions at the end of routine PT plus supplemental sessions 4-weeks and 8-weeks following PT. The ATT control condition included supplemental sessions at 4-weeks and 8-weeks focused on general evaluation of surgical recovery benchmarks. Primary outcomes were weekly minutes of moderate to vigorous physical activity (MVPA), measured with an accelerometer, and peak force loading symmetry (limb symmetry index; LSI) during a 10 ​m walk, measured with a 3-sensor in-shoe device. General linear mixed models compared changes in outcomes between randomized groups at 3-month and 6-month follow-up. Results: Both PAS and ATT groups increased MVPA, but there were no clinically meaningful between-group differences at 3- or 6-month follow-up (p ​> ​0.05). There were also no clinically meaningful between-group differences LSI at 3- or 6-month follow-up (p ​> ​0.05). Conclusion: The PAS intervention did not yield improvements beyond ATT control. It is possible that PAS components were being delivered as part of routine PT, and a more intensive intervention (e.g., more visits, guidance for exercise progression) or targeted approach (e.g., those with deficits at end of routine care) may be needed to further improve outcomes.
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spelling doaj-art-ba4262f5f0ee477e85713cd7f5dcef4f2024-11-27T05:03:08ZengElsevierOsteoarthritis and Cartilage Open2665-91312024-12-0164100534Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trialRobin M. Queen0Liubov Arbeeva1Daniel N. Bracey2Derek Hales3Carla Hill4Katie F. Huffman5Todd A. Schwartz6Kelli D. Allen7Kevin Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USAThurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USADepartment of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USACenter for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USADivision of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAThurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAThurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAThurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA; Corresponding author. Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC 27599, USA.Objective: This pilot trial examined a Physical Activity and Symmetry (PAS) intervention focused on common deficits of physical inactivity and joint loading asymmetry following total knee arthroplasty (TKA). Design: Participants (n ​= ​60) were enrolled during routine physical therapy (PT) following TKA and randomized to the PAS intervention or an attention (ATT) control group. The PAS intervention included physical activity counseling and balance exercise to address joint loading symmetry; content was delivered during 2 sessions at the end of routine PT plus supplemental sessions 4-weeks and 8-weeks following PT. The ATT control condition included supplemental sessions at 4-weeks and 8-weeks focused on general evaluation of surgical recovery benchmarks. Primary outcomes were weekly minutes of moderate to vigorous physical activity (MVPA), measured with an accelerometer, and peak force loading symmetry (limb symmetry index; LSI) during a 10 ​m walk, measured with a 3-sensor in-shoe device. General linear mixed models compared changes in outcomes between randomized groups at 3-month and 6-month follow-up. Results: Both PAS and ATT groups increased MVPA, but there were no clinically meaningful between-group differences at 3- or 6-month follow-up (p ​> ​0.05). There were also no clinically meaningful between-group differences LSI at 3- or 6-month follow-up (p ​> ​0.05). Conclusion: The PAS intervention did not yield improvements beyond ATT control. It is possible that PAS components were being delivered as part of routine PT, and a more intensive intervention (e.g., more visits, guidance for exercise progression) or targeted approach (e.g., those with deficits at end of routine care) may be needed to further improve outcomes.http://www.sciencedirect.com/science/article/pii/S2665913124001018ArthroplastyPhysical therapyBiomechanicsExercise
spellingShingle Robin M. Queen
Liubov Arbeeva
Daniel N. Bracey
Derek Hales
Carla Hill
Katie F. Huffman
Todd A. Schwartz
Kelli D. Allen
Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trial
Osteoarthritis and Cartilage Open
Arthroplasty
Physical therapy
Biomechanics
Exercise
title Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trial
title_full Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trial
title_fullStr Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trial
title_full_unstemmed Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trial
title_short Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trial
title_sort physical activity and symmetry following total knee arthroplasty results of a pilot randomized trial
topic Arthroplasty
Physical therapy
Biomechanics
Exercise
url http://www.sciencedirect.com/science/article/pii/S2665913124001018
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