Everyday Physical Activity and Sedentary Behavior After Total Joint Arthroplasty: Do Patients and Partners Develop an Active Lifestyle?

Figures & data

Table 1 Characteristics Among OA Patients and Their Partners

Characteristics	OA Patients (n or M±SD)	Partners (n or M±SD)	Difference Between Groups (t-Test/Chi-Square)
Time between assessments	11.8 ± 1.3 months (range 11–16 months)		–
Demographics
Age	69.4 ± 7.2 (range 52–81 years)	69.1 ± 8.6 (range 50–83 years)	p = 0.885
Gender	11 male, 13 female	13 male, 11 female	χ^2 = 0.333; p = 0.564
BMI^a	26.6 ± 3.8	27.0 ± 4.1	p = 0.775
Education^b	6 sl1, 13 sl2, 3 tl^§	10 sl1, 11 sl2, 2 tl^§	χ^2 = 1.345; p = 0.510
Occupation^c	19 r, 3 pt, 2 ft	18 r, 2 pt, 4 ft	χ^2 = 0.894; p = 0.640
Comorbidities^d	1.3 ± 0.8 (range 0–3)	1.1 ± 0.9 (range 0–3)	p = 0.397
Perioperative details
Affected joint	17 hip, 7 knee	–	–
Initial diagnosis of OA	6.9 ± 6.6 (range 0.5–28)	–	–
Pain medication^e	4 n, 10 i, 2 w, 3 ww, 5 d	–	–

Notes: ^aBody mass index (body mass divided by the square of the body height [kg/m²]). ^bEducation levels: sl1 (secondary level I; age: 10–15/16 years), sl2 (secondary level II; age: 15–19 years), tl (tertiary level; age: >19 years). ^§Data missing. ^cOccupation (r = retired; pt = part time/occasional job; ft = full time job). ^dPathological conditions (cardiovascular, pulmonary, metabolic, gastrointestinal, liver, kidney, blood, cancer, depression, musculoskeletal diseases) (0 = best condition; 10 = worst condition). ^eAnalgesic consumption related to osteoarthritis (n = none | i = irregular | w = weekly | ww = several times a week | d = daily).

Table 2 Physical Performance of OA Patients and Their Partners

Physical Performance	Patients	Partners	Difference	Correlation Analysis
Total time in sedentary bouts (min)	M [95% CI]
Pre-arthroplasty	24.70 [23.39, 26.00]	22.40 [21.20, 23.60]	F(1,791) = 5.770, p = 0.017*	r = 0.502, p < 0.001
Post-arthroplasty	24.30 [23.08, 25.52]	22.82 [21.60, 24.03]	F(1,796) = 2.328, p = 0.128	r = 0.510, p < 0.001
Change	F(1,379) = 5.403, p = 0.014* (d = 0.029)	F(1,374) = 7.018, p = 0.744 (d = −0.031)		z = −0.147, p = 0.883
Length of sedentary bouts (min)	M [95% CI]
Pre-arthroplasty	14.95 [14.20, 15.71]	14.04 [13.35, 14.73]	F(1,783) = 2.811, p = 0.094	r = 0.354, p < 0.001
Post-arthroplasty	15.20 [14.42, 15.97]	13.86 [13.15, 14.56]	F(1,778) = 5.283, p = 0.022*	r = 0.418, p < 0.001
Change	F(1,366) = 6.319, p = 0.012* (d = −0.030)	F(1,362) = 0.891, p = 0.346 (d = 0.025)		z = −1.015, p = 0.310
Number of steps (#)	M [95% CI]
Pre-arthroplasty	300.06 [280.29, 319.84]	395.57 [369.61, 421.52]	F(1,749) = 28.832, p < 0.001*	r = 0.630, p < 0.001
Post-arthroplasty	319.29 [294.69, 343.89]	366.19 [337.34, 395.04]	F(1,770) = 5.336, p = 0.021*	r = 0.535, p < 0.001
Change	F(1,340) = 2.367, p = 0.125 (d = −0.090)	F(1,349) = 0.395, p = 0.530 (d = 0.110)		z = 1.898, p = 0.058
Total time in MVPA (min)	M [95% CI]
Pre-arthroplasty	3.03 [2.78, 3.29]	4.69 [4.35, 5.04]	F(1,780) = 54.325, p < 0.001*	r = 0.333, p < 0.001
Post-arthroplasty	2.85 [2.60, 3.11]	3.88 [3.57, 4.20]	F(1,752) = 24.055, p < 0.001*	r = 0.420, p < 0.001
Change	F(1,344) = 1.559, p = 0.213 (d = 0.071)	F(1,358) = 0.311, p = 0.578 (d = 0.248)		z = −1.342, p = 0.180

Notes: The analysis of accelerometric data of the two groups was based on individual hourly marginal means (M) (16h, 07:00 a.m. – 11:00 p.m.). Changes were analyzed by means of repeated measures ANOVA, ANOVA and Fisher’s z transformation of correlation coefficients. *Significant result (p < 0.05).

Figure 1 Daytime dependency of the patients' SB before and after arthroplasty. From pre-arthroplasty condition (blue coloring) to post-arthroplasty condition (red coloring), the patients' total time in sedentary bouts decreased (A; p = 0.014) while the average length of sedentary bouts increased (B; p = 0.012). The observed changes were distributed over the course of the day, with the result that no significant change of the investigated parameters could be determined for a single hour (p > 0.999). The data are displayed as M ± 95% CI.

Figure 2 Correlation analysis of the patients’ and their partners’ PA. The correlation of hourly number of steps before arthroplasty (blue coloring, r = 0.630, p < 0.001) and after arthroplasty (red coloring, r = 0.535, p < 0.001) did not change significantly (z = 1.898, p = 0.058).

Table 3 Couple-Specific Performance Ratios of Hourly PA and SB

Couple-Specific Performance Ratios	Pre-arthroplasty	Post-arthroplasty	Analysis of Change in Performance Ratios	Effect Size (Cohen’s d)
Sedentary behavior	Mdn [IQR]
Total time in sedentary bouts (∆ min)	7.58 [2.86, 14.18]	6.25 [2.83, 12.37]	X^2 F(1) = 1.609, p = 0.205	0.016
Length of sedentary bouts (∆ min)	4.89 [1.81, 8.70]	4.68 [2.16, 12.86]	X^2 F(1) = 0.102, p = 0.750	0.007
Physical activity	Mdn [IQR]
Number of steps (∆ #)	92.04 [35.47, 181.61]	78.96 [35.12, 199.40]	X^2 F(1) = 0.868, p = 0.352	−0.114
Total time in MVPA (∆ min)	1.64 [0.60, 3.29]	1.33 [0.57, 2.90]	X^2 F(1) = 0.012, p = 0.914	0.066

Notes: The four accelerometric parameters recorded in the patients and their partners were transformed into couple-specific hourly performance ratios (∆, ie, absolute deviations). Data are presented as medians (Mdn) and interquartile ranges (IQR). There were no significant changes from pre-arthroplasty to post-arthroplasty condition (p ≥ 0.205).

Figure 3 Hourly ratios of the couples’ PA and SB. The hourly deviations of physical performance between the OA patients and their partners were calculated for the accelerometric parameters of SB (A: total time in sedentary bouts, B: average length of sedentary bouts) and PA (C: number of steps, D: total time in MVPA). There were no significant changes from pre-arthroplasty condition (blue coloring) to post-arthroplasty condition (red coloring) (p ≥ 0.205).