Physical activity after total knee arthroplasty: A critical review

Table 1 Summary of studies

Ref.	Study type	Assessment type	Assessment(s)	Duration of follow-up	Physical activity findings
Bauman et al[39]	Cross-sectional	Self-Report Questionnaire	UCLA	1 yr	Engage in moderate to high levels
Bonnin et al[41]	Cross-sectional	Self-Report Questionnaire	Perception	Mean = 44 mo	Mixed results
Brandes et al[25]	Longitudinal	Accelerometry	Activity Monitor (McRoberts; SAM, OrthoCare Innovations)	12-mo	Increase
Chatterji et al[42]	Cross-sectional	Self-Report Questionnaire	Grimby’s Scale	1-2 yr	Engage in moderate levels
de Groot et al[26]	Longitudinal	Self-Report Questionnaire, Accelerometry	PASIPD, Activity Monitor (IDEEA)	6 mo	Self-report: Increase
					Accelerometry: No change
Franklin et al[27]	Longitudinal	Accelerometry	Activity Monitor (SAM, OrthoCare Innovations)	6 mo	Decrease
Hayes et al[28]	Longitudinal	Accelerometry	Activity Monitor (IDEEA)	6 wk, 3 mo, 6 mo, 12 mo	No change
In et al[38]	Longitudinal	Self-Report Questionnaire	LEAS	2 yr	Increase
Jones et al[29]	Longitudinal	Self-Report Questionnaire	Historical Leisure Activity Questionnaire	12 mo	Increase
Kersten et al[30]	Cross-sectional	Self-Report Questionnaire	Short Questionnaire to Assess Health Enhancing Physical Activity	1 to 5 yr	Less than healthy older adults
Krenk et al[31]	Longitudinal	Accelerometry	Activity Monitor (Actiwatch, Philips Respironics)	4 d, 6 d	Decrease
Lachiewicz et al[32]	Longitudinal	Self-Report Questionnaire	LEAS	1 yr, 2 yr	Increase
Meding et al[33]	Cross-sectional	Self-Report Questionnaire	UCLA	20 yr
Tsonga et al[34]	Longitudinal	Self-Report Questionnaire, Accelerometry	PASE, Activity Monitor (Digiwalker, Yamax)	3-6 mo	Increase
Vaidya et al[35]	Longitudinal	Self-Report Questionnaire	LEAS	1 yr	Increase
Vissers et al[37]	Longitudinal	Accelerometry	Activity Monitor (Rotterdam Activity Monitor, Temec Instruments)	6 mo	No comparison performed
Vissers et al[36]	Longitudinal	Accelerometry	Activity Monitor (Rotterdam Activity Monitor, Temec Instruments)	6 mo, 4 yr	No change
Walker et al[40]	Longitudinal	Accelerometry	Activity Monitor (Numact)	3 mo, 6 mo	Increase

LEAS: Lower Extremity Activity Scale; PASE: Physical Activity Scale for the Elderly; UCLA: University of California Los angeles Physical Activity Questionnaire; PASIPD: Physical activity scale for individuals with physical disabilities.

Table 2 Outcome measure reliability and validity

Outcome measure	Reliability	Validity
Grimby’s Scale	N/A	N/A
Historical Leisure Activity Questionnaire	r = 0.690-0.870[54,59]	r = 0.26[54]
LEAS	r = 0.9147[45]	r = 0.79[45]
PASE	ICC = 0.77[60]	r = 0.06-0.45[51]
PASIPD	r = 0.77[53]	r = 0.30[53]
Perception	N/A	N/A
Short Questionnaire to Assess Health Enhancing Physical Activity	r = 0.77[61]	r = 0.45[30]
UCLA	r = 0.86[49]	r = -0.50 – 0.51[62]
Activity Monitor	r2 = 0.98[57]	r2 = 0.91[56]

LEAS: Lower Extremity Activity Scale; PASE: Physical Activity Scale for the Elderly; PASIPD: Physical activity scale for individuals with physical disabilities.

Table 3 Patient characteristics by study

Ref.	N	Age at surgery (mean ± SD)	Body mass index (mean ± SD)	Sex distribution (M/F)	Comorbidities
Bauman et al[39]	184	66.4 ± 9.4	30.6 ± 7.9	76/108	Undisclosed
Bonnin et al[41]	347	74.8 (28-94)	27.9 ± 4.9	120/227	Undisclosed
Brandes et al[25]	53	65.8 ± 5.8	30.7 ± 4.1	19/34	Undisclosed
Chatterji et al[42]	144	70.8 ± 10.4	-	64/80	Undisclosed
de Groot et al[26]	44	62.1 ± 9.7	32.1 ± 5.3	20/24	Undisclosed
Franklin et al[27]	14	-	-	7/14	Undisclosed
Hayes et al[28]	65	61.1 ± 2.2	30.3 ± 2.8	5/7	Undisclosed
In et al[38]	169	66.7 (49-85)	26.4 ± 4.2	152/17	64 with metabolic syndrome, 40 with hypertension, 36 with diabetes, 13 with hypertension and diabetes
Jones et al[29]	90	66.5 ± 9.7	32.6 ± 7.2	36/54	Comorbidity Index of the American Academy of Orthopedic Surgeons Outcomes Data Collection Questionnaires = 0.9 ± 1.2
Kersten et al[30]	844	74.4 ± 11.9	29.4 ± 5.0	229/615	Undisclosed
Krenk et al[31]	20	70.5 (61-89)	26.4 (19-34)	7/13	Undisclosed
Lachiewicz et al[32]	188	71 (41-89)	30.9	49/139	Undisclosed
Meding et al[33]	128	63.8 ± 8.9	-	35/93	Undisclosed
Tsonga et al[34]	52	72.6 ± 5.9	29.79 ± 5.27	-	Undisclosed
Vaidya et al[35]	100	-	-	48/62	55 with diabetes, 65 with hypertension
Vissers et al[37]	44	63.5 (42.0-78.0)	30.8 (24.2-44.9)	20/24	Undisclosed
Vissers et al[36]	21	63.8 ± 9.41	29.7 ± 5.01	9/12	Undisclosed
Walker et al[40]	19	M: 69.1 ± 5, F: 69.0 ± 7.8	-	10/9	Undisclosed

¹Includes total hip arthroplasty patients.