Heightened cardiovascular stress during the six-minute walk test among people with type 2 diabetes

Abstract

Patients usually report alleviation of pain and improvement of function 6 months after TKA surgery. However, whether patients resume sufficient physical activity has not been objectively documented. Purpose: The aim of this study is to determine the physical activity levels and step count per day using accelerometry among peoplewith TKA, due to knee osteoarthritis; and compare results to international guidelines. Secondly, the study aims to determine if physical activity is similar between genders after TKA. Methods: Study participants were tested 6 months after TKA. Each participant wore the Actigraph GT3XE accelerometer device (ActiGraph, Florida, USA) for 4 days including at least one weekend day. Daily activity levels were measured by accelerometry in 10-s epochs. The accelerometer was worn continuously (except bathing and sleeping) and was attached via a comfortable waist band. The outcomes included: mean wear time (h)/day, mean steps/day, mean sedentary time (sitting/lying), and mean time spent in moderate and vigorous activity. ActiLife data analysis software v 5.10.0 was used to download and analyze the data. Statistical analysis was carried out using SPSS (v 20,Chicago, IL). Results: Fifty-three patients with TKA (26 women, mean± SD age 65± 7 years, body mass index 31.3± 5.7 kg/m2) participated in the study. 47 participants underwent unilateral TKA and 6 participants underwent simultaneous bilateral TKA. The participants wore the accelerometers for a mean± SD of 12.8± 1.8 hours per day. Mean steps per day was 6073± 3298 steps. As anticipated, participants spent considerably more time in sedentary activity (563± 94minutes/day) than in moderate and vigorous physical activity (27± 18minutes/day). No differences were found between men and women in wear time (h/day), steps per day or sedentary time; however, women spent less time (mean difference± SED, 12.2± 4.6) than men in moderate and vigorous physical activities (p< 0.05). 6 participants (1 woman) met the recommendation of American Heart Association and Australian National Aging Institute to spend at least 30min per day in moderate activities. Conclusion(s): This study indicates that the majority of participants who have had a TKA do not meet the international physical activity guidelines by 6 months after surgery. Future studies should focus on examining physical activity levels longitudinally. Implications: Physical therapists are well positioned to encourage and educate patients regarding sufficient physical activity, and this should be an integral component of therapy after TKA.