Daily Physical Activity early after Total Hip Arthroplasty
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Background:Daily physical activity early after total hip arthroplasty (THA) is important to prevent postoperative complications and reduce negative consequences of inactivity. The extent of muscle weakness after THA caused by the surgical approach is suggested as a factor for how physically active patients are early after surgery. Purpose: The purpose of this study was to compare daily physical activity in three groups of THA patients undergoing different surgical approaches in a fast track treatment course early after hospital discharge to home. Material and Methods: This prospective cohort study included a total of 63 participants with unilateral hip osteoarthritis under the age of 70 years. Participants were allocated to the direct lateral approach (DLA), the posterior approach(PA), and the anterior approach (AA). Daily physical activity was measured by body-worn activity monitors, activPALs, attached on the participants' thigh during the first four days after hospital discharge. Primary outcome was time in upright positions per 24 hours. Secondary outcomes were time in walking, time in standing, number of steps, and number of upright events per 24 hours.Results: A total of 61 (n=23, DLA; n=19, PA; n=19, AA) participants (mean age 56.2, SD 8.4 years) completed the activity monitoring and were included in the final analyses. There were no significant group differences in any of the measures of daily physical activity (p's>0.153). Participants showed a large variation in time in upright positions (median 3.53, IQR 2.91-4.81 hours), as well as the secondary outcome measures of daily physical activity.Conclusions: There was no difference in daily physical activity early after surgery between THA patients undergoing DLA, PA and AA in a fast-track treatment course. However, the patients spent a relatively high amount of time being physically active.