Are contextual factors associated with activities and participation after total hip arthroplasty? A systematic review

Abner Sergooris; Jonas Verbrugghe; Liesbet De Baets; Mira Meeus; Nathalie Roussel; Rob J E M Smeets; Katleen Bogaerts; Annick Timmermans

doi:10.1016/j.rehab.2022.101712

Are contextual factors associated with activities and participation after total hip arthroplasty? A systematic review

Ann Phys Rehabil Med. 2023 Jun;66(5):101712. doi: 10.1016/j.rehab.2022.101712. Epub 2023 Jan 19.

Authors

Abner Sergooris¹, Jonas Verbrugghe², Liesbet De Baets³, Mira Meeus⁴, Nathalie Roussel⁴, Rob J E M Smeets⁵, Katleen Bogaerts⁶, Annick Timmermans²

Affiliations

¹ REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, UHasselt, Diepenbeek, Belgium. Electronic address: abner.sergooris@uhasselt.be.
² REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, UHasselt, Diepenbeek, Belgium.
³ Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion Research Group (PAIN), Belgium.
⁴ Department Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium; Pain in Motion Research Group (PAIN), Belgium.
⁵ Department Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; Research School CAPHRI and CIR Revalidatie, Eindhoven, the Netherlands; Pain in Motion Research Group (PAIN), Belgium.
⁶ REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, UHasselt, Diepenbeek, Belgium; Department Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.

PMID: 36680879
DOI: 10.1016/j.rehab.2022.101712

Abstract

Objectives: After total hip arthroplasty (THA), over 30% of individuals report activity limitations and participation restrictions. This systematic review aimed to determine the association between contextual factors and outcomes in the activity and participation domain after THA for hip osteoarthritis (OA).

Methods: This systematic review was developed according to the PRISMA guidelines for systematic reviews. PubMed, Web of Science, Embase and Scopus were searched until August 2022. Risk of bias was assessed with the Quality in Prognosis Studies tool (QUIPS).

Results: Twenty-nine articles were included. Eighteen had a high risk of bias, 3 had a low risk of bias, and 8 had a moderate risk of bias. Anxiety was only investigated in studies with high risk of bias but showed a consistent negative association with activities and participation after THA across multiple studies. Evidence was inconsistent regarding the associations between depression, trait anxiety, sense of coherence, big 5 personality traits, educational level, marital status, employment status, job position, expectations and social support, and the activity and participation domain. Optimism, general self-efficacy, cognitive appraisal processes, illness perception, ethnicity, and positive life events were associated with activities and participation but were only investigated in 1 study. No associations were identified across multiple studies for living or smoking status. Control beliefs, kinesiophobia, race, discharge location, level of poverty in neighbourhood, negative life events and occupational factors, were not associated with the activity and participation domain but were only investigated in 1 study.

Conclusion: Methodological quality of the included studies was low. Anxiety was the only factor consistently associated with worse outcomes in the activity and participation domain after THA but was only investigated in studies with high risk of bias. Further research is needed to confirm relationships between other contextual factors and activities and participation after THA.

Registration: PROSPERO CRD42020199070.

Keywords: Cognitions; Emotions; Environmental factors; Osteoarthritis; Personal factors; Social factors.

Publication types

Systematic Review
Review

MeSH terms

Anxiety / etiology
Arthroplasty, Replacement, Hip*
Humans
Osteoarthritis, Hip* / surgery
Prognosis