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

Abstract

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