title: Too much sitting: the population health science of sedentary behavior. Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up Functional capacity and actual daily activity do not contribute to patient satisfaction after total knee arthroplasty Small Increase of Actual Physical Activity 6 Months After Total Hip or Knee Arthroplasty Total hip arthroplasty in patients 50 years or less: do we improve activity profiles? Quality of life and functional outcome after primary total hip replacement. A five-year follow-up. Changes in daily physical activity before and after total hip arthroplasty. A pilot study using accelerometry. Health related quality of life outcomes after total hip and knee arthroplasties in a community based population. Psychological determinants of problematic outcomes following Total Knee Arthroplasty
abstract: Even when adults meet physical activity guidelines , sitting for prolonged periods can compromise metabolic health .  Television ( TV ) time and objective measurement studies show deleterious associations , and breaking up sedentary time is beneficial .  Sitting time , TV time , and time sitting in automobiles increase premature mortality risk . Further evidence from prospect i ve studies , intervention trials , and population -based behavioral studies is required Background Intensive diet and physical activity interventions have been found to reduce cardiovascular disease ( CVD ) risk , but are re source intensive . The American Heart Association recently recommended motivational interviewing ( MI ) as an effective approach for low-intensity interventions to promote health-related outcomes such as weight loss . However , there is limited research evaluating the long-term effectiveness of MI-based interventions on health-related outcomes associated with CVD risk . The current research evaluated the effectiveness of a six-month low-intensity MI intervention in a UK primary -care setting in maintaining reductions in CVD risk factors at12 months post-intervention . Methods Primary -care patients were r and omised to an intervention group that received st and ard exercise and nutrition information plus up to five face-to-face MI sessions , delivered by a physical activity specialist and registered dietician over a 6-month period , or to a minimal intervention comparison group that received the st and ard information only . Follow-up measures of behavioural ( vigorous and moderate physical activity , walking , physical activity stage-of-change , fruit and vegetable intake , and dietary fat intake ) and biomedical ( weight , body mass index [ BMI ] , blood pressure , cholesterol ) outcomes were taken immediately post-intervention and at a 12-month follow-up occasion . Results Intent-to-treat analyses revealed significant differences between groups for walking and cholesterol .  Obese and hypercholesterolemic patients at baseline exhibited significant improvements in BMI and cholesterol respectively among those allocated to the intervention group compared to the comparison group . Post-intervention improvements in other health-related outcomes including blood pressure , weight , and BMI were not maintained . Conclusions The present study suggests that a low-intensity MI counselling intervention is effective in bringing about long-term changes in some , but not all , health-related outcomes ( walking , cholesterol levels ) associated with CVD risk . The intervention was particularly effective for patients with elevated levels of CVD risk factors at baseline . Based on these findings future interventions should be conducted in a primary care setting and target patients with high risk of CVD . Future research should investigate how the long-term gains in health-related outcomes brought about by the MI-counselling intervention in the current study could be extended to a wider range of health outcomes Background After total knee arthroplasty ( TKA ) only 75 - 89 % of patients are satisfied . Because patient satisfaction is a prime goal of all orthopaedic procedures , optimization of patient satisfaction is of major importance . Factors related to patient satisfaction after TKA have been explored , but no studies have included two potentially relevant factors , i.e. the functional capacity of daily activities and actual daily activity . This present prospect i ve study examines whether functional capacity and actual daily activity ( in addition to an extensive set of potential factors ) contribute to patient satisfaction six months after TKA . Methods A total of 44 patients were extensively examined preoperatively and six months post surgery . Functional capacity was measured with three capacity tests , focusing on walking , stair climbing , and chair rising . Actual daily activity  was measured in the patient 's home situation by means of a 48-hour measurement with an Activity Monitor . To establish which factors were related to patient satisfaction six months post surgery , logistic regression analyses were used to calculate odds ratios . Results Preoperative and postoperative functional capacity and actual daily activity had no relation with patient satisfaction . Preoperatively , only self-reported mental functioning was positively related to patient satisfaction . Postoperatively , based on multivariate analysis , only fulfilled expectations regarding pain and experienced pain six months post surgery were related to patient satisfaction . Conclusions Functional capacity and actual daily activity do not contribute to patient satisfaction after TKA . Patients with a better preoperative self-reported mental functioning , and patients who experienced less pain and had fulfilled expectations regarding pain postoperatively , were more often satisfied Abstract Limitation in daily physical activity is one of the reasons for total hip arthroplasty ( THA ) or total knee arthroplasty ( TKA ) . However , studies of the effects of THA or TKA generally do not determine actual daily activity as part of physical functioning . We determined the effect of THA or TKA on patients ’ actual physical activity and body function ( pain , stiffness ) , capacity to perform tasks , and self-reported physical functioning . We also assessed whether there are differences in the effect of the surgery between patients undergoing THA or TKA  and whether the improvements vary between these different outcome measures . We recruited patients with long-st and ing end-stage osteoarthritis of the hip or knee awaiting THA or TKA .  Measurements were performed before surgery and 3 and 6 months after surgery . Actual physical activity improved by 0.7 % . Patients ’ body function , capacity , and self-reported physical functioning also improved . The effects of the surgery on these aspects of physical functioning were similar for THA and TKA . The effect on actual physical activity ( 8 % ) was smaller than on body function ( 80%–167 % ) , capacity ( 19%–36 % ) , and self-reported physical functioning ( 87%–112 % ) . Therefore , in contrast to the large effect on pain and stiffness , patients ’ capacity , and their self-reported physical functioning , the improvement in actual physical activity of our patients was less than expected 6 months after surgery . Level of Evidence : Level I , prospect i ve study . See the Guidelines for Authors for a complete description of levels of evidence The primary objective of this study was to use step activity monitoring to quantify activity changes after total hip arthroplasty in patients 50 years or less . Secondly , we investigated whether step activity measurements correlated with the Harris hip and UCLA scores . We prospect ively analyzed 37 patients ( age ≤ 50 ) treated with primary THA .  Patient activity was recorded with a step activity monitor .  Harris hip and UCLA scores were analyzed . Total daily stride counts increased by an average of 30.0 % . Increases were noted in the percent of daily time spent at high , moderate and low activity . Increases in daily time spent at high activity moderately correlated with the UCLA activity score but did not correlate with the HHS . Both the UCLA score and the HHS did not correlate with mean daily strides . Following THA , patients ≤ 50 years of age increase their activity by taking more daily strides and improve their activity profile by spending more time at higher activity . Improvements in step activity moderately correlate with improvements in UCLA scores We have evaluated the quality of life and functional outcome after  unilateral primary total hip replacement ( THR ) . Between 5 January 1998 and 31 July 2000 , we recruited a consecutive series of 627 patients undergoing this procedure and investigated them prospect ively . Each was assessed before operation and review ed after six months , 18 months , three years and five years . The  Short Form-36 Health Survey ( SF-36 ) and Harris Hip scores  were evaluated at each appointment . All dimensions of the SF-36 except for mental health and general health perception , improved significantly after operation and this was maintained throughout the follow-up . The greatest improvement was seen at the six-month assessment . On average , women reported lower SF-36 scores pre-operatively , but the gender difference did not continue post-operatively . The Harris Hip scores improved significantly after operation , reaching a plateau after 18 months . The improved quality of life was sustained five years after THR The present single-centre prospect i ve follow-up study assessed the objective changes in physical activity undertaken before and after  total hip arthroplasty ( THA ) using accelerometry . We enrolled 12 female patients who underwent home-based accelerometry assessment one month before and six months after the THA procedure .  We assessed the daily amount of physical activity and energy expenditure related to physical activities . We also recorded the intensity of the physical activity , and pre- and post-operative clinical evaluation with the Harris Hip Score ( HHS ) . At 6 months after surgery , we found a statistically significant increase of the total energy cost of physical activity ( DA ) ( P=0.02 ) , without significant increase of activity time ( P>0.05 ) . The energy cost of moderate/vigorous activity was statistically significant increased after surgery ( P=0.008 ) . Finally , HHS improved form 53.9±15.3 pre-operatively to 78.1±12.2 post-operatively ( P=0.03 ) . In our patients , the improvement was significant only for the total energy cost of daily activity . Thus , although patients did not exhibit a more active lifestyle , as shown by the slight increase of the activity time , they significantly increased the amount of moderate or vigorous activities performed after surgery OBJECTIVE To quantify the magnitude of change seen with pain , function , and quality of life outcomes 6 months after  total hip and knee arthroplasties ( THA , TKA )  within a community based cohort of a regional health district . METHODS An inception cohort of 504 patients who received primary THA ( 228 ) or TKA ( 276 ) was prospect ively followed . All patients resided in the community and were assessed within one month prior to surgery and 6 months postoperatively . Health related quality of life measures were evaluated with the Western Ontario and McMaster Universities ( WOMAC ) Osteoarthritis Index and the Medical Outcome Survey Short Form SF-36 . Perioperative factors were extracted from medical charts . Health services utilization data were collected from regional health data bases . RESULTS Over 75 % of patients reported improvement in joint-specific pain and function , regardless of the type of joint replaced . Other health dimensions such as social function , bodily pain , physical function , vitality , and general health showed significant improvement after surgery . Those psychosocial dimensions with modest changes had baseline values comparable to age and sex adjusted normal values ; whereas , bodily pain and physical function , which had large changes , had values lower than the normal values . Ninety-one percent of patients receiving THA were satisfied with their surgery , whereas 77 % were satisfied with their TKA . The average length of stay was 7 days and the in-hospital complication rate was 0.34 per patient . CONCLUSION Large improvements were reported for pain and function after joint arthroplasties , while small to moderate changes were seen in other areas related to quality of life .  Patients with hip arthroplasties showed greater improvement in pain and function and were more satisfied with their outcomes than patients with knee arthroplasties . Although pain and function show large improvements , bodily pain and physical function were less than the values reported in the general population ABSTRACT The primary objective of the present study was to examine the role of pain‐related psychological factors in predicting pain and disability following Total Knee Arthroplasty ( TKA ) . The study sample consisted of 75 ( 46 women , 29 men ) individuals with osteoarthritis of the knee who were scheduled for TKA .  Measures of pain severity , pain catastrophizing , depression , and pain‐related fears of movement  were completed prior to surgery . Participants completed measures of pain severity and self‐reported disability 6 weeks following surgery . Consistent with previous research , cross‐sectional analyses revealed significant correlations among measures of pre‐surgical pain severity , pain catastrophizing , depression and pain‐related fears of movement . Prospect i ve analyses revealed that pre‐surgical pain severity and pain catastrophizing were unique predictors of post‐surgical pain severity ( 6‐week follow‐up ) . Pain‐related fears of movement were predictors of post‐surgical functional difficulties in univariate analyses , but not when controlling for pre‐surgical co‐morbidities ( e.g. back pain ) . The results of this study add to a growing literature highlighting the prognostic value of psychological variables in the prediction of post‐surgical health outcomes . The results support the view that the psychological determinants of post‐surgical pain severity differ from the psychological determinants of post‐surgical disability . The results suggest that interventions design ed to specifically target pain‐related psychological risk factors might improve post‐surgical outcomes
target: Physical activity did not change at 6 months , and a small to moderate improvement was found at 12 months postsurgery , despite large improvements in quality of life , pain , and physical function .
  Reasons for the lack of increased PA are unknown but may be behavioral in nature , as a sedentary lifestyle is difficult to change .
background: OBJECTIVE Little is known about the extent to which  physical activity ( PA )  levels change following total knee or hip joint replacement relative to pain , physical function , and quality of life .
  Our objective was to conduct a systematic review and meta- analysis on changes in PA relative to pain , quality of life , and physical function  after total knee or hip joint replacement .