Hammett T, et al. - This meta-analysis focused on the changes in physical activity (PA) relative to pain, quality of life and physical function after total knee or hip joint replacement. Results revealed that physical activity did not change at 6-months and a small-moderate improvement was found at 12-months post-surgery, despite large improvements in quality of life, pain, and physical function. Although, reasons for the lack of increased PA were unknown but might be behavioral in nature as the sedentary lifestyle was difficult to change. Thus, new strategies should be implemented to change sedentary behavior in these subjects.

Methods

• The authors explored PubMed (Medline), Embase and Cinahl, for peer-reviewed, English-language cohort studies measuring PA with an accelerometer from pre-surgery to post-surgery.
• To produce standardized mean differences (SMDs) for PA, quality of life, pain, and physical function outcomes, random-effects models were used.
• Heterogeneity was measured with I².

Results

• Only 7 studies (336 participants) met eligibility criteria. 
• No significant increase in PA was found at 6-months (SMD 0.14; 95% CI -0.05 to 0.34; I ²=0%) and a small-moderate significant effect was found for increasing PA at 12-months (SMD 0.43; 95% CI 0.22 to 0.64; I ²=0%).
• Large improvements at 6-months in physical function (SMD 0.97; 95% CI 0.12 to 1.82; I ²=92.3%), pain (SMD -1.47; 95% CI -2.28 to -0.65; I ²=91.6%), and quality of life (SMD 1.02; 95% CI 0.30 to 1.74; I ²=83.2%) were found.