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.
Paul W Kline, Shawn L Hanlon, Vanessa L Richardson and 5 others
PMID 39826881WHAT IT FOUND
At discharge after total knee replacement rehabilitation, slower Timed Up-and-Go and lower self-reported physical health predicted fewer average daily steps six months later.
Functional capacity alone did not guarantee activity.
Key findings
01At 14 weeks after total knee replacement, a slower Timed Up-and-Go time and lower physical health subscale score predicted lower average daily steps at 38 weeks.
02A better Timed Up-and-Go time at 14 weeks predicted higher peak walking cadence at 38 weeks.
03No 14-week measure significantly predicted reaching at least 7500 average daily steps at 38 weeks.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was determined for the parent trial primary outcome, not for this secondary predictive analysis. Complete data came from 87 of 92 randomized Veterans, and the regression models included 82 participants for daily steps and 76 for peak cadence. The sample was 87.4% male and limited to US Military Veterans, so it may not represent women, non-Veterans, or different care models. Participants were more physically active before surgery than typical published average step counts. The rehabilitation protocol was highly standardized and may not reflect usual practice patterns. The study cannot determine causation; it found predictors, not effects of treatment. No 14-week measure predicted reaching at least 7500 daily steps, and fewer than 42% of participants achieved that step count. The paper reports average peak cadence below the 100 steps per minute threshold for moderate-intensity walking.
Declared interests
No conflicts of interest statement is provided in the supplied text. The publication types list research support from the U.S. Government, non-PHS, and NIH Extramural.
The easy way to misread this
Do not conclude that improving Timed Up-and-Go time or self-reported physical health will make patients reach 7500 daily steps. This secondary analysis found associations, and no 14-week measure predicted reaching that threshold.