Increased Free-Living Brisk Walking Cadence Following a Physical Activity Behavior Intervention After Total Knee Arthroplasty: A Secondary Analysis of a Randomized Controlled Trial.

OBJECTIVE

To compare the effects of physical activity behavior change intervention (PABC) on durations (total time and bouts of sitting, standing, and stepping) and free-living walking cadence patterns for people recovering from unilateral total knee arthroplasty (TKA).

DESIGN

Secondary analysis of a randomized controlled trial.

SETTING

Veterans Affairs Medical Center.

PARTICIPANTS

Ninety-two (N=92) United States military Veterans.

INTERVENTIONS: Standardized rehabilitation for 12 weeks following TKA plus random assignment to either a PABC or attention-control intervention (CTL).

MAIN OUTCOME MEASURES: Sitting, standing, and stepping patterns (daily total time and bouts) and free-living walking cadence patterns were measured using thigh-mounted triaxial accelerometry (activPAL3) for 10 consecutive days. Outcomes were analyzed with a linear mixed model that estimated mean between-group differences within 2-4 weeks pre-TKA and post-TKA at 8, 14, and 38 weeks.

RESULTS

No between-group differences were observed at any time point for sitting, standing, or stepping total times or average bout durations. The PABC group spent significantly more time walking at a brisk cadence compared to CTL (P<.001), with the largest group difference noted at 38 weeks, which was 24 weeks after intervention end (∆=8.36 min; 95% confidence interval, 4.83-11.88).

CONCLUSIONS

The study suggests that PABC helped Veterans after TKA increase and sustain the duration of daily brisk cadence walking. Future investigations should incorporate the PABC to explore potential interventions to reduce sedentary behavior and assess how improvements in the duration of daily brisk cadence post-TKA affect long-term mobility, functional, and pain outcomes.