KNOWLEDGE OF THE WORLD HEALTH ORGANISATION GUIDELINES ON PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOUR IN PEOPLE AFTER TOTAL KNEE REPLACEMENT

A. Hodges¹, D. Parisi¹, A. Harmer², S. Dennis^2,3, M. Constantinou⁴

¹Australian Catholic University, North Sydney, Australia, ²University of Sydney, Camperdown, Australia, ³Ingham Institute for Applied Medical Research, Liverpool, Australia, ⁴Australian Catholic University, Brisbane, Australia

Background: Osteoarthritis affects 1 in 11 Australians and is associated with pain and functional disability. People with knee osteoarthritis are often physically inactive and excessively sedentary, which increase the risk of developing additional non-communicable diseases. Total knee replacements are thought to reduce pain and improve function. However, patients remain physically inactive and excessively sedentary up to one year following surgery. The World Health Organisation (WHO) guidelines on physical activity and sedentary behaviour can educate patients on minimal levels of activity for health. However, it is unclear if patients are aware and or meeting these guidelines at one year after a total knee replacement.

Purpose: To determine whether patients who underwent a total knee replacement one year ago have knowledge of the WHO guidelines on physical activity and sedentary behaviour. Also, to identify the proportion of people who meet the physical activity guidelines (>150 mins moderate aerobic activity per week, over at least 5 days per week) and the proportion who are excessively sedentary (sitting/reclining ³6h per day).

Methods: A cross-sectional observational study was undertaken at one public and three private hospitals in New South Wales from 2017-2022. Data was collected from 55 patients who underwent a primary unilateral total knee replacement for osteoarthritis 11-15 months ago. A study-designed questionnaire was used to determine if patients had knowledge of the WHO Guidelines on physical activity and sedentary behaviour. Moderate-vigorous physical activity and sedentary time in minutes were measured on four consecutive days using ActiGraph wrist accelerometers. Secondary outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Body Mass Index, the Global Physical Activity Questionnaire (GPAQ), and the Short Form 12-item Health Survey.

Results: A lack of knowledge of the World Health Organisation Guidelines on physical activity and sedentary behaviour was apparent in 91% (n=50/55) of the cohort. Encouragingly, all patients (n=42) for whom accelerometery data were available met the physical activity recommendations. Data on sedentary time was available for 40 of the 42 patients and revealed that 82.5% (n=33) were excessively sedentary.

Conclusions: Most patients in our cohort were unaware of the WHO recommendations for physical activity and sedentary behaviour. While all patients met the recommendations for physical activity, they were unaware that it needed to take place on most days of the week to obtain health benefits. A majority of patients were excessively sedentary, and therefore at risk of developing additional non-communicable diseases.

Implications: Knowledge of the World Health Organisation guidelines on physical activity and sedentary behaviour may have a positive effect on reducing non-communicable diseases in patients after total knee replacement surgery, and therefore improve quality of life and longevity. Physiotherapists are ideally placed to educate patients about the World Health Organisation guidelines on physical activity and sedentary behaviour, and the implications for health.

Funding acknowledgements: The Physiotherapy Research Foundation supported the project with grant funds.

Keywords:
Physical activity
Sedentary behaviour
Knee Osteoarthritis

Topics:
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: University of Sydney

Committee: Human Research Commitee

Ethics number: 2016/638