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Habitual Physical Activity Behavior of Patients After Primary Total Hip Arthroplasty

R Wagenmakers, MD, is Orthopedic Surgeon, Department of Orthopedics, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands.
M Stevens, PhD, is Research Coordinator, Department of Orthopedics, University Medical Center Groningen, University of Groningen.
W Zijlstra, PhD, is Human Movement Scientist, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen.
ML Jacobs, MSc, is Physical Therapist, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen.
I van den Akker-Scheek, PhD, is Human Movement Scientist, Department of Orthopedics, University Medical Center Groningen, University of Groningen.
JW Groothoff, PhD, is Professor of Work and Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen.
SK Bulstra, MD, PhD, is Professor of Orthopedics, Department of Orthopedics, University Medical Center Groningen, University of Groningen.

r.wagenmakers{at}orth.umcg.nl

Background and Purpose: Despite recognized health benefits of physical activity, little is known about the habitual physical activity behavior of patients after total hip arthroplasty (THA). The purpose of this study was to analyze this behavior and the fulfillment of guidelines for health-enhancing physical activity of these patients compared with a normative population.

Subjects and Methods: The participants were 273 patients who had undergone a primary THA (minimum of 1 year postoperatively). Comparisons were made between this group and 273 age- and sex-matched individuals from a normative population. Comparisons also were made between participants with THA under 65 years of age and those 65 years of age and older and among participants with THA in different Charnley classes. Level of physical activity was assessed with the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH).

Results: No significant differences in total amount of physical activity or time spent in different categories of physical activity were found between the THA group and the normative group. Participants with THA spent significantly more minutes in activities of moderate intensity compared with the normative group. Participants with THA who were under 65 years of age were significantly more active than older participants with THA. Charnley class had significant effects on time spent at work, time spent in moderate-intensity activities, and total amount of activity, with the least activity performed by participants in Charnley class C. The guidelines were met by 51.2% of the participants with THA and 48.8% of the normative population. Female participants met the guidelines less frequently than male participants in both the combined groups (odds ratio=0.50, 95% confidence interval=0.35–0.72, P<.001) and the THA group (odds ratio=0.48, 95% confidence interval=0.28–0.80, P=.001).

Discussion and Conclusion: The results suggest that patients after THA are at least as physically active as a normative population. Nevertheless, a large percentage of these patients do not meet the guidelines; therefore, they need to be stimulated to become more physically active.

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