Physical Activity and Sedentary Behavior Subsequent to Serious Orthopedic Injury: A Systematic Review

Christina L Ekegren; Ben Beck; Rachel E Climie; Neville Owen; David W Dunstan; Belinda J Gabbe

doi:10.1016/j.apmr.2017.05.014

Physical Activity and Sedentary Behavior Subsequent to Serious Orthopedic Injury: A Systematic Review

Arch Phys Med Rehabil. 2018 Jan;99(1):164-177.e6. doi: 10.1016/j.apmr.2017.05.014. Epub 2017 Jun 16.

Authors

Christina L Ekegren¹, Ben Beck², Rachel E Climie³, Neville Owen⁴, David W Dunstan⁵, Belinda J Gabbe⁶

Affiliations

¹ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia. Electronic address: christina.ekegren@monash.edu.
² Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
³ Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
⁴ Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Swinburne University of Technology, Melbourne, Australia; Department of Medicine, Monash University, Melbourne, Australia; Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Australia; School of Public Health, University of Queensland, Brisbane, Australia.
⁵ Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; School of Public Health, University of Queensland, Brisbane, Australia; Mary McKillop Institute of Health Research, Australian Catholic University, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia; School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia.
⁶ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Farr Institute, Swansea University Medical School, Swansea University, Swansea, United Kingdom.

PMID: 28629991
DOI: 10.1016/j.apmr.2017.05.014

Abstract

Objective: To systematically review and synthesize the evidence on physical activity and sedentary behavior after serious orthopedic injury.

Data sources: Eight electronic databases and reference lists of relevant articles were searched from inception to March 2016.

Study selection: Studies on physical activity and sedentary behavior measured objectively or via self-report among patients with a serious orthopedic injury (acute bone or soft tissue injury requiring emergency hospital admission and/or nonelective surgery) were included.

Data extraction: Data extraction and methodological quality assessment were independently performed by 2 reviewers using standardized checklists.

Data synthesis: Twelve of 2572 studies were included: 8 were on hip fractures and 4 on other orthopedic injuries. Follow-up ranged from 4 days to 2 years postinjury. When measured objectively, physical activity levels were low at all time points postinjury, with individuals with hip fracture achieving only 1% of recommended physical activity levels 7 months postinjury. Studies using objective measures also showed patients to be highly sedentary throughout all stages of recovery, spending 76% to 99% of the day sitting or reclining. For studies using self-report measures, no consistent trends were observed in postinjury physical activity or sedentary behavior.

Conclusions: For studies using objective measures, low physical activity levels and high levels of sedentary behaviors were found consistently after injury. More research is needed not only on the impact of immobility on long-term orthopedic injury outcomes and the risk of chronic disease, but also the potential for increasing physical activity and reducing sedentary behavior in this population.

Keywords: Exercise; Orthopedics; Rehabilitation; Review; Sedentary lifestyle; Wounds and injuries.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Exercise / psychology*
Health Behavior*
Hip Fractures*
Humans
Musculoskeletal System / injuries*
Sedentary Behavior*
Trauma Severity Indices