Trial reportArchives of physical medicine and rehabilitation2025
Functional Capacity at Rehabilitation Discharge Predicts Physical Activity Characteristics 24 Weeks Later for People With Total Knee Arthroplasty: A Secondary Analysis of a Randomized Controlled Trial.
Trial report in Archives of physical medicine and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo determine the association between performance-based and patient-reported functional capacity at the conclusion of 12-week rehabilitation with average daily step counts and peak walking cadence 38 weeks after total knee arthroplasty (TKA).
designSecondary analysis of a randomized controlled trial.
settingVeterans Affairs Medical Center.
participantsA total of 87 US military Veterans (age: 67±7y, 87% male).
interventionsTwelve-week rehabilitation beginning 2 weeks post-TKA plus random assignment to either a telehealth-based physical activity behavior change intervention or control group.
main outcome measuresPerformance-based (timed Up-and-Go [TUG], 30-second sit-to-stand) and patient-reported measures (Western Ontario and McMaster Universities Osteoarthritis Index, Veterans RAND 12-Item Health Survey [VR-12]) were assessed at rehabilitation discharge (14wk post-TKA). Physical activity was measured using thigh-mounted accelerometry 38 weeks post-TKA. Relationships between participant characteristics (age, sex, body mass index, group assignment), functional capacity at discharge, and long-term physical activity outcomes (average daily step count and peak walking cadence) were evaluated using single- and multiple-variable linear and logistic regressions.
resultsUnivariate analyses: TUG time (r=-0.33, P=.002) and VR-12 physical health subscore (r=0.23, P=.036) were correlated with average daily step count at week 38. TUG time (r=-0.31, P=.006) was correlated with peak walking cadence. Multivariate analyses: multiple linear regression controlling for age, sex, and body mass index identified TUG (B=-301.25, P=.039) and VR-12 physical health (B=93.1, P=.049) as predictors of daily step count. TUG time (B=-1.5, P=.012) and assignment to physical activity behavior change intervention (B=13.7, P<.001) predicted peak walking cadence. No significant predictors of attaining a 7500 steps per day threshold were identified.
conclusionsFunctional capacity at discharge is related to physical activity characteristics 38 weeks post-TKA. Although behavior change interventions are needed to address physical activity deficits postoperatively, the link between functional capacity and activity suggests additional need to address functional capacity limitations during TKA rehabilitation.
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