A mixed methods approach to investigating physical activity in people with obesity participating in a chronic care programme awaiting total knee or hip arthroplasty.

Autor: Pavlovic N; South Western Sydney Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.; Fairfield Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia., Brady B; Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.; School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia.; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia., Boland R; Fairfield Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia., Harris IA; Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.; Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.; School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia., Flood VM; University Centre for Rural Health, Northern Rivers, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia., Genel F; Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.; St George and Sutherland Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia., Gao M; Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia., Naylor JM; South Western Sydney Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.; Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.
Jazyk: angličtina
Zdroj: Musculoskeletal care [Musculoskeletal Care] 2023 Dec; Vol. 21 (4), pp. 1447-1462. Date of Electronic Publication: 2023 Sep 29.
DOI: 10.1002/msc.1825
Abstrakt: Aims: To describe patient-reported physical activity and step count trajectory and explore perceived barriers and enablers to physical activity amongst people with obesity participating in a chronic care programme whilst awaiting arthroplasty.
Design: Convergent parallel mixed-method study.
Method: A patient cohort derived from a longitudinal sample of adults with end-stage osteoarthritis and obesity from a chronic care programme whilst awaiting primary total knee or hip arthroplasty (n = 97) was studied. Physical activity was measured at baseline (entry to the wait list) and before surgery (9-12 months waiting time) using the Lower Extremity Activity Scale (LEAS) and activity monitors (activPAL™). A subset of participants completed in-depth semi-structured interviews 6 months after being waitlisted to explore perceived barriers and enablers to physical activity. Themes were inductively derived and then interpreted through the COM-B model.
Results: Baseline LEAS and activPAL™ data were available from 97 and 63 participants, respectively. The proportion of community ambulant individuals reduced from 43% (95% CI 33%-53%) at baseline to 17% (95% CI 9%-28%) pre-surgery. Paired activPAL™ data (n = 31) for step count, upright time, and stepping time remained unchanged. Twenty-five participants were interviewed. Five themes underpinning physical activity were mapped to the COM-B model components of capability (physical capability), opportunity (accessibility and social norms), and motivation (self-efficacy and beliefs and physical activity).
Conclusions: Participation in a chronic care programme did not improve physical activity levels for people with obesity awaiting arthroplasty. Programs cognisant of the COM-B model components may be required to address the natural trajectory of declining physical activity levels while awaiting arthroplasty.
(© 2023 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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