Changes in 24-Hour Physical Activity Patterns and Walking Gait Biomechanics After Primary Total Hip Arthroplasty: A 2-Year Follow-up Study

Jasvir S. Bahl, Stuart C. Millar, François Fraysse, John B. Arnold, Mark Taylor, Stuart Callary, Lucian B. Solomon, Dominic Thewlis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Despite marked improvements in self-reported pain, perceived functional ability, and gait function following primary total hip arthroplasty (THA), it remains unclear whether these improvements translate into improved
physical activity and sleep behaviors. The aim of this study was to determine the change in 24-hour activity profile (waking activities and sleep) and laboratory-based gait function from preoperatively to 2 years following the THA.

Methods: Fifty-one patients undergoing primary THA at a single public hospital were recruited. All THAs were performed using a posterior surgical approach with the same prosthesis type. A wrist-worn accelerometer was used to capture 24-hour activity profiles preoperatively and at 1 and 2 years postoperatively. Three-dimensional gait analysis was performed to determine changes in temporospatial and kinematic parameters of the hip and pelvis.

Results: Patients showed improvements in all temporospatial and kinematic parameters with time. Preoperatively, patients were sedentary or asleep for a mean time (and standard deviation) of 19.5 ± 2.2 hours per day. This remained unchanged up to 2 years postoperatively (19.6 ± 1.3 hours per day). Sleep efficiency remained suboptimal (<85%) at all time points and was worse at 2 years (77% ± 10%) compared with preoperatively (84% ± 5%). More than one-quarter of the sample were sedentary for >11 hours per day at 1 year (32%) and 2 years (41%), which was greater than the preoperative percentage (21%). Patients accumulated their activity performing light activities; however, patients performed less light activity at 2 years compared with preoperative levels. No significant differences (p = 0.935) were observed for moderate or vigorous activity across time.

Conclusions: Together with improvements in self-reported pain and perceived physical function, patients had significantly improved gait function postoperatively. However, despite the opportunity for patients to be more physically active postoperatively, patients were more sedentary, slept worse, and performed less physical activity at 2 years compared with preoperative levels.

Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Original languageEnglish
Pages (from-to)1166-1174
Number of pages9
JournalThe Journal of bone and joint surgery. American volume
Volume103
Issue number13
DOIs
Publication statusPublished - 7 Jul 2021

Bibliographical note

Update
This article was updated on July 19, 2021, because of a previous error. On page 1172, in the Results section entitled “Sedentary Activity,” the sentence that had read “Postoperatively, 32% at 1 year and 14% at 2 years were sedentary for >11 hours per day.” now reads “Postoperatively, 32% at 1 year and 41% at 2 years were sedentary for >11 hours per day.”
An erratum has been published: J Bone Joint Surg Am. 2021 August 18; 103(16):e68.

Keywords

  • total hip arthroplasty (THA)
  • self-reported pain
  • perceived functional ability
  • gait function
  • 24-hour activity profile
  • change in 24-hour activity profile
  • laboratory-based gait function
  • Three-dimensional gait analysis

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