Exploring physical activity and sedentary behaviour: perspectives of individuals with osteoarthritis and knee arthroplasty.

Purpose: To explore the understanding of physical activity and sedentary behaviour, including barriers and health influences in people with osteoarthritis and knee arthroplasty.Methods: Eight participants with knee osteoarthritis and 14 participants with total knee arthroplasty were recruited to five focus groups. Interpretive description was used with thematic analysis of data.Results: Three primary themes arose: (1) continuum of activity; (2) barriers to increasing physical activity and barriers to reducing sedentary behavior, and (3) knowledge gap. While participants were generally familiar with the concepts of physical activity and sedentary behaviour, they were not aware of health risks associated with high levels of sedentary time and did not consider substituting standing and light walking for activities typically done in sitting. Participants reported that extrinsic barriers (e.g., related to social and cultural contexts or the physical environment) influenced sedentary behaviour more than intrinsic factors.Conclusions: Patients would benefit from clinicians providing education about risks associated with sedentary behaviour and strategies to reduce and/or break up sitting time. Future research should continue to explore personal as well as societal, environmental, political, and economic influences on sedentary behaviour and physical activity to promote behaviour change.Implications for rehabilitationPeople with osteoarthritis and total knee arthroplasty are not aware of health risks associated with high levels of sedentary behaviour.This cohort tends to think about increasing moderate-to-vigorous physical activity levels (versus increasing light activity) when asked to consider ways to reduce sedentary behaviour.Social and environmental factors strongly influence sedentary behaviour. Clinicians need to be aware of the pervasive nature of sedentary behaviour and provide knowledge and strategies to change peoples' sitting habits.Addressing intrinsic factors (e.g., related to comorbidities, ageing, and personal preferences) with education and the use of existing behaviour change techniques may enable increased physical activity levels.

Sedentary Behavior, Cadence, and Physical Activity Outcomes after Knee Arthroplasty.

PURPOSE: This study comprehensively examined sedentary behavior and physical activity patterns in people with severe knee osteoarthritis awaiting total knee arthroplasty (TKA) and in individuals after TKA. METHODS: Preoperative (n = 32, mean ± SD = 69.9 ± 5.3 yr) and 1-yr postoperative participants with TKA (n = 38, 67.9 ± 7.3 yr) wore ActiGraph GT3X+ activity monitors for 6.8 ± 0.6 d. Total sedentary time, time in long sedentary bouts (≥30 min), and physical activity outcomes (steps, time in moderate-to-vigorous physical activity [MVPA], cadence) were examined. RESULTS: There were no differences between pre- and postoperative groups for total sedentary time (9.3 ± 1.4 vs 9.2 ± 1.4 h·d, P = 0.62) and number of long sedentary bouts per day (median [interquartile range] = 3.4 [1.9] vs 3.1 [2.0], P = 0.37). Daily steps, peak 30-min cadence, and peak 1-min cadence values were greater in people after TKA compared with those awaiting surgery (5935 [3316] vs 3724 [2338], 55.6 [31.0] vs 35.9 [19.3], and 91.5 ± 20.6 vs 70.0 ± 23.7, respectively, all P < 0.01). There were no differences in lifestyle MVPA between groups. The number of bouts of Freedson MVPA was greater in postoperative participants, but the differences were not substantial (one bout per week). CONCLUSION: Patients report less knee pain and improved function after TKA; however, sedentary behavior does not differ and physical activity is only marginally increased compared with those awaiting surgery. After TKA, daily walking at slow, moderate, and brisk paces and engagement in MVPA do not match levels seen in healthy older adults, which, when combined with high levels of sedentary behavior, leaves patients at increased risk for physical disability and cardiovascular disease.